ASSOCIATION OF PLACENTA PREVIA WITH A HISTORY OF PREVIOUS CESARIAN DELIVERIES AND INDICATIONS FOR A POSSIBLE ROLE OF A GENETIC COMPONENT
Matalliotakis M, Velegrakis A, Goulielmos GN, Niraki E, Patelarou AE, Matalliotakis I
*Corresponding Author: Dr. Michail Matalliotakis, Venizeleio & Pananio General Hospital of Heraklion, Knossos Avenue, 71409 Heraklion, Greece. Tel: +30-281-036-8304. Mobile: +30-694-386-1582. Fax: +30-281-036-8305. E-mail: mihalismat@hotmail.com
page: 3

INTRODUCTION

Placenta previa is a serious obstetric complication of pregnancy, representing a major cause of vaginal bleeding after 20 weeks of gestation in which the placenta is partially or fully attached to the internal cervical ostium (os) and may develop into adverse maternal and fetal outcome [1]. The frequency among all pregnancies is approximately 0.3-0.5%, with predominant risk factors being advanced maternal age, gestation with male fetuses, smoking, multiparity, history of previous Cesarian sections (C-sections) and/or habitual abortion, conditions that may lead to damage of the endometrial tissue [2]. The etiology remains enigmatic but some risk factors seem to be superior. According to the trophotropic theory, the placenta migrates to better vascularized areas. Normally, the placenta grows towards the fundus, which can provide more blood. Defective vascularization of the endometrium due to scarring or atrophy caused by previous operations or infections may result in reduced differential growth of the lower uterine segment and less of an upward shift in placental location [3]. There is an evident literature support that male gender correlates with the low implantation of the placenta. Mac- Gillivray et al. [4] proposed that the time of insemination during the menstrual cycle plays a role in male conception and the site of the implantation. It has been previously suggested that a multi disciplinary medical team is needed for further evaluation and management of these cases because a massive hemorrhage may need obstetric hysterectomy, intensive care and blood transfusions [5]. In the framework of this study, we sought to correlate the frequency of placenta previa to previous C-sections, to determine the effect of male gender in this condition and to further evaluate the maternal outcome.



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