ABSTRACT
Placenta previa is associated with high morbidity and mortality rates due to major hemorrhage during surgery. Thus, a standard surgical approach with a low risk of morbidity is required. This study aimed to propose surgical steps for placenta previa with scarred uterus. All deliveries at the Al-Karak governmental hospital between January 2019 and January 2022 were retrospectively reviewed. Placenta previa cases were divided into 2 groups according to management. Group A was managed by incising the uterus at the level of the fundus to avoid disrupting the placenta, whereas group B was managed by opening the lower uterine segment and delivering the baby through the placenta after the incision. A total of 26 cases with placenta previa were included in this study. Group A (nâ =â 12) was managed by avoiding the placenta and group B (nâ =â 14) was managed by opening through the placenta. No differences were noted between the 2 groups regarding demographics. Patients who underwent the suggested surgical approach (Group A) had less blood loss (medianâ =â 775 cc), whereas Group B (medianâ =â 1700 cc) (Pâ =â .001) had significantly higher blood loss. The duration of hospital stay was significantly shorter in Group A (medianâ =â 2 days) than in Group B (medianâ =â 6 days) (Pâ =â .000). Incising the upper uterine segment to avoid the placenta may lead to better outcomes in terms of blood loss and its consequences.