PREGNANCY OUTCOME OF WOMEN WITH PREVIOUS CESAREAN SECTION ACCORDING TO PLACENTAL LOCATION IN FIRST TRIMESTER SONOGRAPHY

Abstract

Author(s): Mojgan Barati, Azam Malekghasemi, Razieh Mohammad Jafari, Sara Masihi, Najmieh Saadati, Farideh Maramazi

Moreover, the first trimester ultrasonography provides a valuable evaluation for predicting pregnancy outcomes. Our purpose was to determine whether ultrasonography of placental location at 11-14 weeks of gestation (first trimester) can predict neonatal and maternal pregnancy outcomes. The observational and prospective study from July 2011 to October 2012 was conducted on the 200 pregnant women with previous cesarean. Placental locations were determined by ultrasonography at 11-14 weeks’ gestation, and then were classified into four groups including anterior high, anterior low, posterior high and posterior low. Parameters such as Preterm Labor, Preterm Premature Rupture of Membrane, neonatal Birth Weight, occurrence of bleeding throughout pregnancy were followed up. Our results showed that the anterior low group had highest rate of bleeding throughout pregnancy compared with groups of posterior low, anterior high and posterior high (40 %, 34 %, 4 %, 6 %, respectively, p < = 0.001); furthermore, there was significant correlation between rising the number of previous cesareans and increasing the incidence of the anterior low placental implantation (P value = 0.03). Anterior low group had lowest average of neonatal birth weight (p-value < 0.001), while anterior high group had highest average of neonatal birth weight compared with other groups. We believe that the ultrasound procedure was valid and enabled us to evaluate the pregnancies at first stages of pregnancy (11-14 weeks). Therefore, it can be used in evaluating the pregnancies to categorize them as being at risk for an adverse ante partum, intra partum and neonatal outcomes.