PT  - JOURNAL ARTICLE
AU  - Shaamash, Ayman H.
AU  - AlQasem, Mehad H.
AU  - Mahfouz, Ahmed A.
AU  - Al Ghamdi, Deama S.
AU  - Almanie, Norah I.
AU  - Eskandar, Mamdoh A.
TI  - Impact of high-order repeat cesarean deliveries on early maternal complications among major placenta previa patients in Southern Saudi Arabia
AID  - 10.15537/smj.2024.45.10.20240329
DP  - 2024 Oct 01
TA  - Saudi Medical Journal
PG  - 1049--1056
VI  - 45
IP  - 10
4099  - http://smj.org.sa/content/45/10/1049.short
4100  - http://smj.org.sa/content/45/10/1049.full
SO  - Saudi Med J2024 Oct 01; 45
AB  - Objectives: To investigate the rates and odds ratios (ORs) of early maternal complications among patients with major placenta previa (PP) who have undergone high-order repeat cesarean deliveries (HOR-CDs) in comparison to those with low-order repeat cesarean deliveries (LOR-CDs).Methods: We carried out a retrospective review of all major PP patients (n=184) who delivered through second or subsequent repeat CDs, from January 2012 to December 2021 (Abha Maternity and Children’s Hospital, Abha, Saudi Arabia). The patients were categorized into 2 groups: the LOR-CDs group (n=100), comprising individuals with their second and third CDs (CD2-CD3) and the HOR-CDs group (n=84), consisting of those undergoing their fourth to seventh CDs (CD4-CD7).Results: In comparison to the LOR-CDs, the HOR-CDs group with major PP exhibited significantly higher rates and ORs of early maternal complications, including MRI-diagnosed placenta accreta spectrum (PAS, OR=2.67), transfusions of packed red blood cells (OR=2.71), moderate to severe intra-operative bleeding (OR=1.80), emergency hysterectomy (OR=2.96), urological injuries (OR=3.17), and length of post-operative hospital stay (OR=3.91). The major PP subgroup undergoing CD6-CD7 showed the highest rates and ORs for PAS diagnosis at 84.6% (OR=3.98) and emergency hysterectomy at 28.6% (OR=4.04).Conclusion: Among patients with major PP, undergoing more than 3 CDs is associated with a notable increase in both the rates and ORs of various early maternal complications. This trend of increasing many complications correlates directly with an ascending number of CDs.