Resumo

SEGOVIA VAZQUEZ, MR. Cesarean delivery. An. Fac. Cienc. Méd. (Asunción) [online]. 2015, vol.48, n.1, pp.23-40. ISSN 1816-8949.  https://doi.org/10.18004/anales/2015.048(01)23-040.

ABSTRACT INTRODUCTION: Cesarean delivery failure occurs in the reconstitution of the endometrium-myometrium in a subsequent pregnancy and is associated with increased risk of complications from placenta previa and placenta adherent, increasing morbidity and mortality from hemorrhage. The objective of this study was to determine the association of abnormal placental implantation and adherence in patients with previous cesarean scar treated at the National Hospital (Itauguá) for 5 years (2006-2010). SUBJECTS AND METHODS: retrospective cohort study, which compared the presence and absence of previous cesarean section and the development of placental abnormalities. RESULTS: 1776 women entered the study with previous cesarean section and 13,984 without it. We found 164 (1%) patients with placental abnormalities. The incidence of placental abnormalities in the cohort with cesarean section was 46.2 / 1000 and placental adhesions were 22.5 / 1000. The cesarean section resulted in a very high risk for the development of placental abnormalities RR 7.8 (95% CI 5.8 to 10.7 p <0.0001). This risk increased linearly with the number of previous cesareans, multiparity, age greater than 30 years. Mortality associated with placental abnormalities was 0.6%. DISCUSSION: the presence of previous cesarean scar was a very high risk for the development of placental abnormalities. Key Words: cesarean section, placental abnormalities

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