P15.16: The risk factors of emergency cesarean hysterectomy for placenta previa

To investigate the clinical risk factors and third-trimester transvaginal ultrasonographic placental findings associated with emergency cesarean hysterectomy performed because of complicated placenta previa. We retrospectively reviewed the records and compared between 28 patients with pregnancies complicated by placenta previa who underwent cesarean hysterectomy and 266 patients with pregnancies complicated by placenta previa who did not undergo cesarean hysterectomy. Emergency cesarean hysterectomy was performed in 28 patients (9.5%). No significant differences on the basis of maternal age, parity, the number of abortion, the number of cesarean section, gestational age and the number of antenatal vaginal bleeding between two groups. And emergency cesarean section has more tendency to emergency hysterectomy compared to elective cesarean section. On the basis of third-trimester transvaginal sonographic findings, the distance from the internal os of cervix was not associated with emergency hysterectomy. However, significant differences were found on the lower placental edge thickness and the presence of lacuna in the placenta between two groups. Patients with placenta previa are at a higher risk of undergoing cesarean hysterectomy if the emergency cesarean section is performed and the lower placenta edge is thick and lacuna is showed in the placenta. The other clinical factors such as maternal age, parity, the number of abortion, the number of cesarean section, gestational age, the number of vaginal bleeding and sonographic finding such as the distance of placenta from internal os might not be associated with the risk of cesarean hysterectomy.