Muzibunnisa Begam
Mediclinic Airport Road Hospital, UAE
Title: Placenta accreta and caesarean scar pregnancy: Potential risks of rising caesarean section rate
Biography
Biography: Muzibunnisa Begam
Abstract
A retrospective study of women diagnosed with Caesarean section Scar Pregnancy (CSP) by ultrasound andor histopathology was conducted to determine outcome and to explore the possible causative mechanisms. Over a period of 3 years, a total of 16,926 deliveries and 3554 Caesarean Sections (CS) occurred in the institution. Nine cases of CSP were identified with an incidence of 1:1880 births and 0.25% of all CS. The mean number of previous CS in women with scar pregnancies was 2.4 with seven (77.7%) patients had multiple CS. The time interval between the current CSP and the previous CS ranged from 1-10 years (Mean, 3.7 years). All women with known indication for the previous CS had undergone the procedure without labor (88.8%). Six (75%) patients underwent CS at preterm gestation and two patients had term elective procedure for breech presentation. The main clinical presentation was vaginal bleeding in six (66.6 %) patients. Diagnosis was established early in five (55.5%) patients. The uterus was preserved in 7 of the 9 (77.7%) patients. All seven reported regular normal menstruation and one patient (11.1%) conceived spontaneously. Our study has indicated that the risk of CSP may be related to the indications of the previous CS as the number of CS alone could not explain the occurrence of CSP. To the best of our knowledge, this is the first study that has looked specifically at the relationship between the indications of previous CS with CSP. It is time to explore this area so that screening strategies can be generated to detect CSP at the earliest possible gestation so as to prevent complications from this life-threatening condition. Further, our review of MAP has shown that it is best managed in tertiary referral centers utilizing multidisciplinary comprehensive approach.