Sonographic Assessment of Placenta Previa with and without History of Cesarean Section or Abortion

Abstract

Background: The incidence of placenta Previa has increased with increasing maternal age due to late marriages.

Objective: To assess occurrence of placenta Previa in females with and without history of C- section, abortion and both.

Methodology: Descriptive cross sectional study conducted in Sir Ganga Ram Hospital Lahore, radiology department. Duration of study was nine months after the approval of synopsis. Main aim was to assess occurrence of placenta Previa in females with and without history of C-section and abortion or both. The examination will start with the patient in the supine position (3.5 – 5 MHz) convex probe will be used .From the anteriorly using urinary bladder as acoustic window ultrasound will be performed in the longitudinal planes. In Transabdominal study (TAS) the bladder will be adequately distended to visualization of the cervix and lower uterine segment and to check the relationship of the placenta to the inner os. If indicated, positioning the patient in a right or left posterior oblique position may be helpful to check the posterior placenta. The diagnosis of placenta Previa will be considered if the lower placental edge covers the internal os.

Results: In antenatal setup 357 pregnant females were scanned in their second and third trimester for fetal growth and placental position and location after taking obstetrical history and clinical examination. After completion of the nine months of data regarding the complete obstetrical and surgical history were noted in a performa/questionnaire and analyzed using SPSS. The study found that 90 females were diagnosed as cases of placenta Previa with both H/O C- section and abortion. The Mean and SD value of maternal age of 357 pregnant females were 29.78 and 3.42. Data was classified into 2 groups: <29 years and >29 years of maternal age. Cross tabulation was developed between age groups and history of C- section, abortion or both. Mean and SD values < 29 years maternal age were 26.82and 1.03, Mean and SD value >29years maternal age were 31.99and 2.86. It was clear from the study that placenta Previa is associated with old C-section, abortion and both. There is association increasing maternal age chances of Placenta Previa increased (P=0.000 <0.05) P VALUE 0.000, OR=2.75, CI=1.633---4.759.The study concludes that ultrasound is best modality to diagnosis placenta Previa.

Conclusion: In this study we determined the chances of placenta Previa increase with Maternal age, H/O previous C- section , H/O abortion and both H/O C-section, abortion .We found significant P VALUE 0.000, Odds ratio 2.76, Confidence interval 1.633---4.76. Hence we can conclude that USG is a reliable and sensitive modality for the placenta Previa localization.

Keywords: placenta Previa, abortion, placenta localization