Factores de riesgo de placenta previa en mujeres embarazadas en un hospital de República Dominicana

Abstract

[Español] Introducción: la hemorragia obstétrica es una de las causas de morbilidad y mortalidad materna más común en todo el mundo. La placenta previa es un factor de riesgo importante para la hemorragia obstétrica. El propósito de este estudio es determinar los factores de riesgo relacionados con placenta previa en mujeres embarazadas en Santo Domingo. Métodos: los casos fueron mujeres cuyos partos fueron complicados con placenta previa y los controles fueron partos sin placenta previa. Se analizaron 16 casos y 76 controles. Se condujo análisis estadístico y se calculó razón de probabilidades (OR). Resultados: se demostró relación entre placenta previa con antecedente de dos o más abortos con un OR = 5.3; con cesárea previa OR = 3.02, que aumentaba con más de 2 cesáreas con un OR = 5.91, con embarazo ectópico previo y antecedente de placenta previa. Las pacientes con placenta previa y antecedente de cirugía tuvieron un mayor riesgo de requerir una histerectomía. Las mujeres con placenta previa y antecedentes de cesáreas múltiples (2 o más) tuvieron un mayor riesgo de padecer placenta acreta con un OR = 18. Discusión: nuestro estudio sugiere que abortos múltiples, cesárea previa, múltiples cesáreas anteriores, antecedente de placenta previa y antecedente de embarazo ectópico son factores de riesgo de desarrollar placenta previa.

[English] Introduction: Obstetric hemorrhage is one of the most common causes of maternal morbidity and mortality worldwide. Placenta previa is an important risk factor for obstetric hemorrhage. The purpose of this study is to determine the risk factors related to placenta previa in pregnant women Santo Domingo. Methods: The cases were women whose deliveries were complicated with placenta previa and the controls were deliveries without placenta previa. 16 cases and 76 controls were analyzed. Statistical analysis was conducted and odds ratio (OR) was calculated. Results: The relationship between placenta previa with a history of two or more abortions with an OR = 5.3 was demonstrated; with previous caesarean section OR = 3.02, which increased with more than 2 caesarean sections with an OR = 5.91, with previous ectopic pregnancy and diagnosis of placenta previa in a previous pregnancy. Patients with placenta previa and a history of surgery had a higher risk of requiring a hysterectomy. Women with placenta previa and a history of multiple caesarean sections (2 or more) had a higher risk of suffering from placenta accreta with an OR = 18. Discussion: Our study suggests that multiple abortions, previous caesarean section, multiple previous caesarean sections, antecedents of placenta previa and history of ectopic pregnancy are risk factors of developing placenta previa.