PREDICTION OF PLACENTA ACCRETA ASSOCIATED WITH PLACENTA PREVIA


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Abstract

Pregnancy complicated by placenta previa is associated with a high risk of adverse outcomes, primarily with massive hemorrhage, which is largely due placenta accreta. Aim. To determine prognostically significant risk factors for placenta accreta associated with placenta previa. Materials and methods. Continuous sampling method was used to analyze the cases, when women had deliveries with placenta previa in history. The anamnesis data, birth outcomes, blood loss in patients with placenta accreta associated with placenta previa (n=117) and placenta previa without accretion (n=268) were compared. Results. Placenta accreta occurred in 30.4% of women with placenta previa. Of them in 44.8% of cases, it was due to the presence uterine scars. Among the patients with placenta accreta, parity (p=0.039) and the number of births (p=0.001) was higher. In cases of abdominal delivery, 29.9% of women had obstetric hemorrhage. In patients with placenta accreta, the volume of blood loss was 3 times higher than in women without placenta accreta (p=0,001). The presence of an uterine scar after cesarean section was prognostically more significant in relation to placenta accreta associated with placenta previa (sensitivity - 93.2%, specificity - 76.5%). Conclusion. The women with obstetric hemorrhage in cases of placenta previa are in a high-risk group for the development of massive hemorrhage. The presence of an uterine scar, more than two births in history, and delivery at ≥ 36. 5 weeks are prognostic criteria for placenta accreta in pregnant women with placenta previa.

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About the authors

Sergey V. BARINOV

Omsk State Medical University, Ministry of Health of Russia

Email: barinov_omsk@mail.ru
MD, Professor, Head of the Department of Obstetrics and Gynecology №2 Omsk, Russia

Irina V. MEDYANNIKOVA

Omsk State Medical University, Ministry of Health of Russia

Email: mediren@gmail.com
MD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk, Russia

Yuliya I. TIRSKAYA

Omsk State Medical University, Ministry of Health of Russia

Email: yulia.tirskaya@yandex.ru
MD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk, Russia

Galina B. BEZNOSHCHENKO

Omsk State Medical University, Ministry of Health of Russia

Email: akusheromsk@rambler.ru
MD, Professor, professor of the Department of Obstetrics and Gynecology №2 Omsk, Russia

Tatyana V. KADTSYNA

Omsk State Medical University, Ministry of Health of Russia

Email: tatianavlad@list.ru
PhD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk, Russia

Oksana V. LAZAREVA

Omsk State Medical University, Ministry of Health of Russia

Email: lazow@mail.ru
PhD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk, Russia

Alina V. BINDYUK

Perinatal Center, Regional Clinical Hospital

Email: alina1905@yandex.ru
PhD, obstetrician-gynecologist of the Obstetric Physiological Department Omsk, Russia

Tatyana N. NEUSTROEVA

Omsk State Medical University, Ministry of Health of Russia; Perinatal Center, Republic of Sakha (Yakutia) Republican Hospital No. 1

Email: tatyananikl234@mail.ru
post-graduate student, Department of Obstetrics and Gynecology №2, Omsk State Medical University; Head of the Department of Gynecology, Perinatal Center, Sakha (Yakutia) Republican Hospital №1. Yakutsk, Russia

Sergey S. STEPANOV

Omsk State Medical University, Ministry of Health of Russia

Email: serg_stepanov@mail.ru
MD, Associate Professor, Senior laboratory assistant of the Department of Histology Omsk, Russia

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