Placenta previa. The true increment of the placenta

Abstract

Relevance: According to the literature, the incidence of placenta previa is 0.1%-1% of all deliveries, and the incidence of complete placenta previa is 20-30% of all placenta previa. The main causes of maternal mortality in the true placenta previa are massive obstetric hemorrhage,
hemorrhagic shock, and disseminated intravascular coagulation syndrome.
The study aimed to identify the etiopathogenesis, clinical picture, diagnosis of true placenta rotation, modern methods of delivery, and their outcomes in patients with true placenta rotation against the background of complete placenta previa; analysis of the obtained data in a comparative aspect to determine the most appropriate technique for performing cesarean section and intraoperative surgical hemostasis.
Materials and Methods: We conducted a retrospective analysis of 130 histories of births with PPP, delivered at the Center for Perinatology and Pediatric Cardiac Surgery (Almaty, Kazakhstan) from 01/01/2021 to 12/31/2023.
Results: In our study, the incidence of placenta previa was: in 2021 - 45 cases out of 9171 births (0.47%), in 2022 - 46 cases out of 8002 births (0.57%), in 2023 - 39 cases out of 8575 births (0.45%). An analysis of complaints upon admission, life history data, obstetric and gynecological
history, and methods for diagnosing IVP, timing, and methods of cesarean section (transverse incision in the lower segment/bottom incision) and their outcomes in patients with IVP against the background of PPP showed the feasibility of using modern organ-preserving technologies with IVP.
Conclusion: The results of our study confirm the advisability of performing a bottom cesarean section in all cases of true placenta accreta (confirmed by ultrasound) against the background of its complete presentation to reduce the amount of intraoperative blood loss and preserve the reproductive function of patients.