Cesarean section and placental disorders in subsequent pregnancies – a meta-analysis

  title={Cesarean section and placental disorders in subsequent pregnancies – a meta-analysis},
  author={Maximilian Klar and Karin B. Michels},
  journal={Journal of Perinatal Medicine},
  pages={571 - 583}
Abstract Background: Despite an increase in the number of cesarean deliveries conducted worldwide, meta-analyses on the long-term effect of cesarean section (CS) on subsequent placental disorders are sparse. Objective: To examine the association between CS and three major types of placental disorders (placental abruption, placenta previa, and placenta accreta with its variants increta/percreta) in subsequent pregnancies. Search strategy: We followed the MOOSE consensus statement for meta… 

Figures from this paper

Mode of delivery and preterm birth in subsequent births: A systematic review and meta-analysis
This is the first systematic review and meta-analysis that suggests previous cesarean section could increase the risk of preterm birth in subsequent pregnancies and could provide policy makers, clinicians, and expectant parents to reduce the occurrence of unnecessary cesar section.
Characteristics and outcomes of pregnant women with placenta accreta spectrum in Italy: A prospective population-based cohort study
Antenatal suspicion of PAS is associated with improved maternal outcomes, also among high-risk women with both placenta previa and prior CS, likely because of their referral to specialized centers for PAS management.
Placental complications in subsequent pregnancies after prior cesarean section performed in the first versus second stage of labor
Prior CD due to NPL2 as opposed to N PL1 is independently associated with adherent placenta in the subsequent delivery, and a higher index of suspicion may be needed when evaluating these women during pregnancy as well as during management of the delivery.
Clinical analysis of second-trimester pregnancy termination after previous caesarean delivery in 51 patients with placenta previa and placenta accreta spectrum: a retrospective study
Terminating a pregnancy by vaginal delivery through medical induction of labor may be feasible if clinicians have an overall understanding of gestational age, the type of placenta previa status, thetype of plicenta accreta, and patients concerns about preserving fertility.
Late preterm birth and previous cesarean section: a population-based cohort study
  • Abdool S Yasseen Iii, K. Bassil, A. Sprague, M. Urquia, J. Maguire
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2019
PCS was associated with higher risk of LPB in subsequent pregnancies, may be due to an increased risk of subsequent unplanned or emergency preterm cesarean sections.
Association between first caesarean delivery and adverse outcomes in subsequent pregnancy: a retrospective cohort study
CS in the first delivery markedly increases the risk of repeated CS and maternal-fetal complications in the subsequent pregnancy, especially in women with a non-indicated CS.
Placenta accreta spectrum: maternal near miss
To find out maternal near miss inpatient with PAS which is the most dangerous complication of cesarean potentially leading to massive intrapartum hemorrhage and death especially in developing countries, and to reduce maternal mortality and morbidity associated with placenta accrete spectrum, a randomized prospective surgical case series study is conducted.
A Literature Review of Placenta Accreta Spectrum Disorder: The Place of Expectant Management in Ethiopian Setup
Light is shed on the applicability of the PAS disorder management modalities in the high and middle income countries to shed light on the challenges and successes of placenta accreta spectrum disorders management.
Placenta accreta spectrum disorders – detection rate and maternal outcomes following implementation of an institutional protocol
  • P. Karkhanis, I. Ahmed, S. Irani
  • Medicine
    Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
  • 2021
A high antenatal detection rate for PAS was demonstrated, which has led to timely intervention by an experienced multidisciplinary team and excellent outcomes, and development of institutional screening and management protocol is a necessity for large units.


The association of placenta previa with history of cesarean delivery and abortion: a metaanalysis.
Long-term effects of cesarean sections: ectopic pregnancies and placental problems.
Cesarean section is a modest risk factor for ectopic pregnancy and an important risk factors for placental problems.
Previous Cesarean Delivery and Risks of Placenta Previa and Placental Abruption
A cesarean first birth is associated with increased risks of previa and abruption in the second pregnancy, and there is a dose–response pattern in the risk ofprevia, with increasing number of prior cesAREan deliveries.
Placenta Previa and Prior Cesarean Delivery: How Strong is the Association?
Women with a history of cesarean delivery are 50% more likely to have a subsequent birth complicated by placenta previa than those without such a history, and the magnitude of excess risk is lower than the relative risks reported in previous studies.
Risk of placenta previa in second birth after first birth cesarean section: a population-based study and meta-analysis
There is an increased risk of placenta previa in the subsequent pregnancy after CS delivery at first birth, but the risk is lower than previously estimated.
Placental abruption: critical analysis of risk factors and perinatal outcomes
Since the incidence of placental abruption has increased during the last decade, risk factors should be carefully evaluated in an attempt to improve surveillance and outcome.
The Likelihood of Placenta Previa With Greater Number of Cesarean Deliveries and Higher Parity
Abnormal placentation: twenty-year analysis.
Prior Cesarean and the Risk for Placenta Previa on Second-Trimester Ultrasonography
A previous cesarean delivery did not increase the odds for detecting a placenta previa on second-trimester ultrasonography, suggesting a lower likelihood of resoulion.
The effect of placenta previa on neonatal mortality: a population-based study in the United States, 1989 through 1997.
The risk of neonatal mortality was higher for babies born to women with placenta previa than for babies Born to women without placentA previa who were delivered at > or =37 weeks of gestation, and this crossover also persisted in an analysis by birth weight and term births.