Article Figures & Data
Tables
- Table 1
- Pattern of repeat cesarean deliveries among our major placenta previa patients (N=184).
Variables n (%) Low-order repeat CDs, n=100 (54.3) CD2 47 (25.5) CD3 53 (28.8) High-order repeat CDs, n=84 (45.7) CD4 38 (20.7) CD5 32 (17.4) CD6 11 (5.9) CD7 3 (1.7) Values are presented as numbers and percentages (%).
CDs: cesarean deliveries
- Table 2
- Antenatal maternal characteristics of patients with repeat cesarean deliveries and major placenta previa.
Variables Values Test of significance P-values Maternal age (years), mean±SD LOR-CDs (CD2 and CD3) 32.84±5.74 t=2.123* 0.033 HOR-CDs (CD4 - CD7) 34.93±5.33 Gravidity, median (range) LOR-CDs (CD2 and CD3) 4.0 (2-16) Z=4.388† 0.001 HOR-CDs (CD4 - CD7) 6.0 (4-11) Parity, median (range) LOR-CDs (CD2 and CD3) 2.0 (2-9) Z=4.377† 0.001 HOR-CDs (CD4 - CD 7) 4.0 (4-7) Number of CDs, mean±SD LOR-CDs (CD2 and CD3) 2.53±0.50 t=22.532* 0.001 HOR-CDs (CD4 - CD7) 4.75±0.82 PAS on MRI (n=150)§ No PAS 75 (50.0) PAS 75 (50.0) LOR-CDs (CD2 and CD3), n=80 No PAS 49 (61.3) PAS 31 (38.8) HOR-CDs (CD4 - CD7), n=70 8.679‡ 0.005 No PAS 26 (37.1) PAS 44 (62.9) Values are presented as mean ± standard deviation (SD), median (range), or numbers and percentages (%). Maternal characteristics did not show significant differences included: miscarriages; current IVF pregnancy; previous uterine surgery (curettage-evacuation-hysteroscopic surgery); placental location (anterior or posterior); timing of CD (emergency or planned); admission gestational age (weeks); termination gestational age (weeks); antepartum hemorrhage (present or absent); and degree of PAS on antenatal MRI (accreta or increta/percreta).
LOR: low-order repeat, CDs: cesarean deliveries, HOR: high-order repeat, PAS: placenta accreta spectrum, MRI: magnetic resonance imaging
- Table 3
- Early maternal complications among patients with repeat cesarean deliveries and major placenta previa.
Variables n (%) Test of significance P-values RBCs transfusions (units), median (range) LOR-CDs (CD2 - CD3), n=100 2 (0-7) Z=3.011* 0.003 HOR-CDs (CD4 - CD7), n=84 2 (0-13) Hospital stay (days), median (range) LOR-CDs (CD2 - CD3), n=100 3 (1-14) Z=3.729* 0.001 HOR-CDs (CD4 - CD7), n=84 3 (1-15) Intra operative bleeding No to mild bleeding 3.907† 0.048 LOR-CDs (CD2 - CD3) 61 (61.0) HOR-CDs (CD4 - CD7) 39 (46.4) Moderate to heavy LOR-CDs (CD2 - CD3) 39 (39.0) HOR-CDs (CD4 - CD7) 45 (53.6) Emergency hysterectomy (n=28) No 6.563† 0.01 LOR-CDs (CD2 - CD3) 91 (91.0) HOR-CDs (CD4 - CD7) 65 (77.4) Yes LOR-CDs (CD2 - CD3) 9 (9.0) HOR-CDs (CD4 - CD7) 19 (22.6) Urological injuries (bladder and ureter), n=17 No 4.694† 0.03 LOR-CDs (CD2 - CD3) 95 (95.0) HOR-CDs (CD4 - CD7) 72 (85.7) Yes LOR-CDs (CD2 - CD3) 5 (5.0) HOR-CDs (CD4 - CD7) 12 (14.3) Values are presented as numbers and percentages (%) or median and range. Early maternal complications did not show significant differences included: fresh frozen plasma transfusions; pre-operative hemoglobin; post-operative hemoglobin; premature delivery <37 weeks; and emergency CD.
RBCs: red blood cell counts, LOR: low-order repeat, CDs: cesarean deliveries, HOR: high-order repeat
- Table 4
- Univariate analysis for the high-order repeat cesarean delivery (CD4-CD7) as a risk factor for early maternal complications in major placenta previa patients.
Risk Factors LOR-CDs (CD2-CD3) n=100 HOR-CDs (CD4-CD7) n=84 cOR (95% CI) P-values PAS by MRI (n=150)* No PAS (n=75) 49 (61.3) 26 (37.1) 2.67 (1.39-5.16) 0.001 With PAS (n=75) 31 (38.7) 44 (62.9) RBCs transfusions (units) <3 units 83 (83.0) 54 (64.3) 2.71 (1.37-5.37) 0.002 ≥3 units 17 (17.0) 30 (35.7) Intra operative bleeding Normal and mild bleeding 61 (61.0) 39 (46.4) 1.80 (1.01-3.24) 0.045 Moderate and heavy bleeding 39 (39.0) 45 (53.6) Emergency hysterectomy, n=28 No hysterectomy 91 (91.0) 65 (77.4) 2.96 (1.18-6.89) 0.013 Hysterectomy 9 (9.0) 19 (22.6) Lower urinary injuries, n=17 No injuries 95 (95.0) 72 (85.7) 3.17 (1.07-9.34) 0.020 Bladder/ureter injuries 5 (5.0) 12 (14.3) Post operative hospital stay (days) ≤3 days 87 (62.1) 53 (37.9) 3.91 (1.88-8.14) 0.001 >3 days 13 (29.5) 31(70.5) Values are presented as numbers and percentages (%). Variables that did not represent risk factors on univariate regression analysis are not shown in the table including: fresh frozen plasma transfusions (cOR [95% CI]: 1.39 [0.69-2.77]); post-operative hemoglobin (cOR [95% CI]: 1.37 [0.64-2.93]); timing of CD (cOR [95% CI]: 1.31 [070-2.47]); antepartum hemorrhage (cOR [95% CI]: 1.07 [0.51-2.25]); previous uterine surgery (cOR [95% CI]: 1.01 [0.41-2.41]); placental location (anterior or posterior) (cOR [95% CI]: 1.14 [0.49-1.57]); premature delivery <37 weeks (cOR [95% CI]: 1.10 [0.49-1.68]); degree of PAS (accreta or increta/percreta) (cOR [95% CI]: 1.05 [0.42-2.63]).
cOR: crude odds ratios, PAS: placenta accreta spectrum, MRI: magnetic resonance imaging, LOR: low-order repeat, CDs: cesarean deliveries, HOR: high-order repeat, RBCs: red blood cell count, CI: confidence interval
↵* Only 150/184 had MRI.
- Table 5
- Univariate analysis for the stratified number of repeat cesarean deliveries as a risk factor for placenta accreta spectrum diagnosis and hysterectomy in major placenta previa patients.
Risk factors No PAS by MRI* (n=75) PAS by MRI* (n=75) cOR (95% CI) P-values CD2-CD3 (n=80) 49 (61.3) 31 (38.8) Reference CD4-CD5 (n=57) 24 (42.1) 33 (57.9) 2.17 (1.03-4.61) 0.037 CD6-CD7 (n=13) 2 (15.4) 11 (84.6) 3.98 (1.4-14.29) 0.003 Risk factors No hysterectomy (n=156) Hysterectomy (n=28) cOR (95% CI) P-values CD2-CD3 (n=100) 91 (91.0) 9 (9.0) Reference CD4-CD5 (n=70) 55 (78.6) 15 (21.4) 1.158 (1.01-1.33) 0.020 CD6-CD7 (n=14) 10 (71.4) 4 (28.6) 4.04 (1.09-14.97) 0.003 Values are presented as numbers and percentages (%).
PAS: placenta accreta spectrum, MRI: magnetic resonance imaging, cOR: crude odds ratios, CI: confidence interval
↵* Only 150/184 had MRI.
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