SCARRED UTERUS;

FREQUENCY OF PLACENTA PRAEVIA

Abstract

Objective: To study frequency of Scarred Uterus in placenta praevia. Design: Descriptive observational study. Place and
Duration Of Study: December 2008-December 2009 Holy family Hospital Rawalpindi. Patients and Methods: 50 patients with placenta
praevia presented to Holy Family Hospital Gynae and Obs unit II during this period. All patients either admitted through emergency or Gynae
outpatient department were included. Results: The mean age of patients with placenta Praevia was 29.04 year with (SD =5.11).The mean
gestational age was 34.6 weeks and (SD = 2.7). Fourteen (28%) patients were gravida 2 and 13(26%) were primigravida. Fifteen (30%) patients
were para 1 & 14 (28%) were para 0. Painless vaginal bleeding was the presenting complaint in 38(76%) patients, whereas 12(24%) patients
were diagnosed on routine ultrasonography. Nine (18%) cases underwent spontanouse vertex delivery and 41 (82%) cases were delivered by
caesarean section. Placenta Praevia type 1 in 7 (14%) cases. Placenta Praevia type 2 in 20 (40%) cases, type 3 in 14 (28%) cases, type 4 in 9
(18%) cases . Previous history of scarred uterus was found in 16 (32%) cases .Post partum haemorrhage occurred in 13 (26%) cases
.caesarean hysterectomy in 5 (10%) cases. Conclusions: A scarred uterus leads to increase frequency of Placenta Praevia, scarring of uterus
can be reduced by keeping the caesarean section rate within reasonable limits and instead of doing surgical evacuation of retained products of
conception, suction and evacuation by suction canula.