LDIA1kICS ||

Cesarean De||very Increases k|sk for Iuture |acenta rev|a and Abrupt|on

8lsks also lncrease as Lhe lnLerval beLween pregnancles decreases
Cesarean dellvery ls now Lhe mosL common operaLlve procedure ln Lhe uS accounLlng
for more Lhan 23 of all dellverles 8ecause cesarean dellvery ls regarded as a poLenLlal rlsk
facLor for placenLa prevla and placenLal abrupLlon ln subsequenL pregnancles lnvesLlgaLors
performed a reLrospecLlve cohorL sLudy of Lhe flrsL Lwo (136473 women) and flrsL Lhree
(31102) slngleLon pregnancles of women ln Mlssourl from 1989 Lo 1997

lncldences of prevla and abrupLlon were 44 and 79 per 1000 slngleLon blrLhs
respecLlvely Cne fourLh of Lhe women had flrsL cesarean dellverles Lhelr rlsks for prevla and
abrupLlon ln Lhelr second pregnancles were 30 and 30 hlgher respecLlvely Lhan rlsks among
women wlLh flrsL vaglnal dellverles 8lsk for prevla ln Lhlrd pregnancles was Lwlce as hlgh ln
women wlLh Lwo prlor cesarean dellverles as ln women wlLh Lwo prlor vaglnal dellverles 8lsks
for prevla and abrupLlon also were hlgher among women wlLh shorLer lnLerpregnancy lnLervals
especlally lf second pregnancles occurred wlLhln 1 year of flrsL pregnancles

CommenL As Lhe percenLage of cesarean blrLhs lncreases cllnlclans musL recognlze Lhe llnked
lncrease ln rlsk for placenLa prevla and placenLal abrupLlon poLenLlal emergencles LhaL can be
assoclaLed wlLh maLernal and feLal deaLh 1he shorLer Lhe lnLerpregnancy lnLerval Lhe greaLer
Lhe rlsks

8oberL W 8ebar Mu

ubllshed ln !ournal WaLch Ceneral Medlclne Aprll 23 2006
hLLp//generalmedlclne[waLchorg/cgl/conLenL/full/2006/423/7

Summary

Cne fourLh of Lhe women had flrsL cesarean dellverles Lhelr rlsks for prevla and
abrupLlon ln Lhelr second pregnancles were 30 and 30 hlgher respecLlvely Lhan rlsks among
women wlLh flrsL vaglnal dellverles 8lsk for prevla ln Lhlrd pregnancles was Lwlce as hlgh ln
women wlLh Lwo prlor cesarean dellverles as ln women wlLh Lwo prlor vaglnal dellverles 8lsks
for prevla and abrupLlon also were hlgher among women wlLh shorLer lnLerpregnancy lnLervals
especlally lf second pregnancles occurred wlLhln 1 year of flrsL pregnancles