[Comparative study of patients with placenta accreta with or without a history of cesarean section]

Abstract

Objective: To evaluate characteristics of placenta accreta (PA) in patients without previous cesarean section.

Material and methods: Retrospective cohort study from December 1993 to April 2010 in two departments of obstetrics in university hospitals, Marseille, France. Comparison of clinical characteristics, circumstances of diagnosis, maternal morbidity and treatment was performed between PA diagnosed in patients with (n=63) and without prior cesarean section (n=35).

Results: In group of patients without previous caesarean section, rate of placenta praevia, and antenatal diagnosis were lower (16/35 [46 %] vs. 44/63 [70 %], [P: 0.02]) and (4/35 [11 %] vs. 28/63 [44 %], [P<0.001]) and rate of pregnancies obtained by IVF was higher (5/35 [15 %] vs. 2/63 [3 %], [P=0.05]). In this group, no hysterectomy was performed but risk of uterus necrosis following embolization was increased (3/35 [8.6 %] patients vs. 0/63 patients [P: 0.02]).

Conclusions: Patients without previous caesarean section have specific characteristics in terms of risk factor and of management.

Keywords: Antécédent de césarienne; Facteurs de risque; Placenta accreta; Previous cesarean section; Risk factors.