Resumo

SEGOVIA VAZQUEZ, María Raquel. Alterations in pregnant women with placenta previous cesarean. Rev. Nac. (Itauguá) [online]. 2013, vol.5, n.1, pp.07-17. ISSN 2072-8174.

ABSTRACT Introduction: Cesarean delivery produces endometrium-myometrium reconstitution failure in subsequent pregnancies and is associated with increased risk of complications due to placenta previa and abnormal placental adhesion, increasing morbidity and mortality from hemorrhage. Objective: to determine the association of abnormal implantation and placental adhesion in patients with previous cesarean sections attended at the National Hospital (Itauguá) during a 5 year period (2006-2010). Material and Methods: retrospective cohort study that 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 the placental adhesions one was 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 cesarean sections, multiparity, age greater than 30 years. Mortality associated with placental abnormalities was 0.6%. Conclusion: the presence of previous cesarean scar resulted a very high risk for the development of placental abnormalities.

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