ASSOCIATION OF PLACENTA PREVIA WITH A HISTORY
OF PREVIOUS CESARIAN DELIVERIES AND INDICATIONS
FOR A POSSIBLE ROLE OF A GENETIC COMPONENT
Matalliotakis M1,*, Velegrakis A1, Goulielmos GN2, Niraki E1, Patelarou AE3, Matalliotakis I1
*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: 5
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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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