Prognostic risk factors for abnormally adherent and invasive placenta in women with placenta located in the area of the uterine scar

Abstract Aim. To identify independent prognostic risk factors for abnormally adherent and invasive placenta (AAIP) in women with a placenta located in the area of a uterine scar. Design. Case-control study. Materials and methods. A study was conducted involving 110 women with placenta located in the area of a uterine scar, divided into two groups: the main group with placenta located in the area of the uterine scar and abnormally adherent and invasive placenta (AAIP) (n = 55) and the control group with placenta located in the area of the uterine scar without AAIP (n = 55). A retrospective analysis was performed using medical records, general and obstetric examination data, and information collected during pregnancy and at the time of hospitalization for delivery. Statistical analysis methods were used to identify significant factors. Results. Despite comparable obstetric and gynecological history, the key prognostic factors for AAIP were features of the current pregnancy: placenta previa (odds ratio (OR) = 70.7; 95% confidence interval (CI) 15.3–326.8); vaginal bleeding after 26 weeks of gestation (OR = 5.7; 95% CI 2.47–12.97); threatened late miscarriage/preterm birth in the 2nd and 3rd trimesters (OR = 4.3 and 3.5, respectively); anemia diagnosed in the 2nd trimester (OR = 2.66; 95% CI 1.2–6.1). Conclusion. In women with placenta located in the area of the uterine scar, in addition to placenta previa, independent prognostic risk factors for AAIP are late-pregnancy bleeding, threatened preterm birth in the 2nd–3rd trimesters, and 2nd-trimester anemia. The establishment of these features will improve the prenatal detection of high-risk patients. Keywords: abnormally adherent and invasive placenta, placenta located in the uterine scar, risk factors, placenta previa, obstetric hemorrhage.