Authors: K Bhatia, Y M Mala, R Tripathi, A Manchanda, M M Singh
A Prospective cohort study conducted at Lok Nayak Hospital India. A clinical history was ob-tained and a transabdominal ultrasound was done for patients with placenta previa. The degree of previa, the location and the number of intraplacental lacunae were recorded. Echolucent area between placenta and uterine wall and the interface between bladder and uterine wall were also analyzed. Color Doppler was used to assess vascularity within the placenta. Subsequently, a score was assigned between 0 to 11. The main outcome measures were occurrence of peripartum complications like blood transfusion, uterine artery embolization and peripartum hysterectomy. The score was correlated with these outcomes and with the incidence of adherent placenta. The incidence of adherent placenta was 3.2%, 13.3%, 57.1 % in patients with no previous caesarean, previous one, previous two caesareans respectively (p value <0.001). Patients with score over 7 had more peripartum complications requiring blood transfusions, operative procedures like uterine artery embolisation and hysterectomy (p<0.001). This scoring model was valid in our population and can also be used to predict occurrence of adherent placenta, 85.7% of patients with scores more than 7 had adherent placenta.
Placenta previa, adherent placenta, placenta accrete, placenta previa complications, placenta previa scoring
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