Between 1994 and 1999, of the 44 357 mothers delivered at the Riyadh Armed Forces Hospital (RAFH), 255 patients had four or more previous caesarean sections (CS). This comprised 0.5% of the obstetric population. One hundred and eighty-nine (74%) had four, 52 (20%) five, 12 (5%) six and two (0.4%) patients had seven CSs. Adhesions were severe in 128 (50%), moderate in 18 (7%), mild in 81 (32%) and no adhesions in 28 (11%) cases. The incidence of placenta praevia was five times that of the overall obstetric population (2.4% vs. 0.5%). One case of uterine rupture occurred, an incidence of 4/1000 cases. The incidence of placenta praevia rises with rising CS rate. Patients with multiple CS and placenta praevia should be counselled regarding the possibility of caesarean hysterectomy. Repeat CS is safe and tubal ligation should be advised, but not forced as it is not an absolute indication for sterilisation.
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http://dx.doi.org/10.1080/01443610120059879 | DOI Listing |
Cureus
December 2024
Obstetrics and Gynaecology, Centro Hospitalar de Leiria, Unidade Local de Saúde da Região de Leiria, Leiria, PRT.
Placenta accreta represents a spectrum of adherent placental anomalies and is an atypical invasion of the placenta. The major predisposing factor is a prior cesarean delivery. Placenta previa is considered an additional risk factor.
View Article and Find Full Text PDFCureus
December 2024
Obstetrics and Gynecology, Duhok Obstetrics and Gynecology Teaching Hospital, Duhok, IRQ.
Aims: To determine the effectiveness of tranexamic acid (TXA) in reducing vaginal bleeding, extending pregnancy duration, and enhancing perinatal outcomes in pregnant women with placenta previa.
Methods: A multicenter, randomized, double-blind clinical trial was conducted at three maternity teaching hospitals in Iraq's Kurdistan region, Azadi Hospital in the north of Iraq, and Al-Azhar University Hospital in Egypt on 146 women with placenta previa. Participants were randomly assigned to two interventional groups in a 1:1 ratio to receive either TXA or Dextrose 5% water (D5W).
Postgrad Med J
January 2025
Saint Louis University, Department of Gastroenterology, 1 N Grand Blvd, St. Louis, MO, 63103, United States.
Introduction: Diabetes Mellitus (DM) affects both the mother and fetus during and after pregnancy. Multiple studies have shown the prognostic impact of DM on maternal and fetal outcomes, but studies at the national level are limited. Therefore, we aimed to conduct this nationwide study.
View Article and Find Full Text PDFGeburtshilfe Frauenheilkd
January 2025
Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria.
Introduction: To evaluate the adherence of Austrian obstetricians to national guideline recommendations by investigating data on the current practice of tocolysis regarding indications, timing and monitoring of tocolysis, choice of tocolytics and serious side effects, maintenance tocolysis, support of decision-making and recommendations at patient's discharge from the hospital.
Materials And Methods: 78 obstetric departments in Austria were invited to participate in a nationwide survey between June 5 and August 31 2023 by answering a web-based questionnaire about clinical standards. The survey was conducted approximately one year after implementation of the AWMF Guideline "Prevention and Therapy of Preterm Birth" 015‑025.
Aust N Z J Obstet Gynaecol
January 2025
Obstetrics and Gynaecology, Mater Mothers Hospital, Brisbane, Queensland, Australia.
Background: Placenta praevia (PP) is a significant obstetric complication associated with antepartum haemorrhage (APH) and adverse maternal and fetal outcomes. Identifying risk factors for APH in women with PP is important for guiding management decisions.
Aims: This study aimed to identify risk factors associated with APH amongst women admitted to a single tertiary hospital with PP.
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