Comparison of Placenta Previa and Placenta Accreta Spectrum Disorder Following Previous Cesarean Section between Women with a Short and Normal Interpregnancy Interval

Abstract

Objectives. The aim of this study is to determine the effect of interpregnancy interval (IPI) on the incidence of placenta previa and placenta accreta spectrum disorders in women with a previous cesarean section. Methods. A prospective cohort three-center study involving parturients who had previous cesarean section was conducted. Participants were included if pregnancy has lasted up to 34 weeks. Parturients with co-existing uterine fibroids, multiple gestations, premature rupture of membranes, and those with prior postcesarean delivery wound infection were excluded. The eligible women recruited were distributed into two groups, namely, short (<18 months) and normal (18–36 months) IPI. The outcome measures were incidences of placenta previa and placenta accreta spectrum disorder and factors associated with the occurrence of placenta previa. A univariate analysis was performed using the chi-square test or Mann–Whitney U test, wherever appropriate, to examine the significance of the differences in clinical variables. Results. A total of 248 women met the inclusion criteria. The incidence of placenta previa by ultrasound was 8.9% and 4.0% for short and normal IPI (odds ratios = 2.32; 95% confidence intervals = 0.78–6.88; p = 0.13 ), respectively. The incidence of placenta accreta spectrum disorder was 1.6% and 0.8% for short and normal IPI (odds ratios = 2.02; 95% confidence intervals = 0.18–22.13; p = 0.57 ), respectively. The only observed significant difference between the clinical variables and placenta previa is the number of cesarean sections ( p = 0.02 ) in women with short IPI. Conclusion. A short interpregnancy interval does not significantly affect the incidence of placenta previa and placenta accreta spectrum disorder following a cesarean section. There is a need for further study with large numbers to corroborate these findings in low- and middle-income settings.

High-risk pregnancy in India: Prevalence and contributing risk factors – a national survey-based analysis

“…The under five-mortality rate for shorter birth intervals was reported to be twice as high as the rate for birth intervals of three or more years [28]. A shorter inter-pregnancy interval was closely associated with premature rapture of membranes, abruptio placenta, placenta praevia, and uterine rupture in women with previous caesarean deliveries [29]. Hence, additional research is needed to address the issue of short birth spacing among Indian women.…”

Fetal outcome of placenta accreta spectrum disorder patients admitted at Cumilla medical college hospital

“…Given that low birth weight is often a harbinger of a range of neonatal complications, including but not limited to respiratory issues and increased susceptibility to infection, this balanced distribution warrants further investigation. 22 It prompts questions about the effectiveness of the medical interventions administered or the quality of antenatal care, and it also opens up avenues for exploring other contributing factors that may be at play. In summary, the study serves not merely as an addition to the existing body of literature but as a nuanced, multi-faceted exploration into the complexities of PASD.…”