Introduction: Abnormal placental implantation or ‘placental invasion’ is a rare, but potentially life‐threatening, complication in the third stage of labor.7 Currently massive obstetric haemorrhage remains one of the leading causes of maternal mortality. Our study focuses on how much uterine scar of previous caesarean section affects placental localisation or invasion and what impact it causes on fetomaternal outcomes.

Aims and objectives: To assess sonographic placental localisation and invasion in cases of scarred and non scarred uterus.and to correlate these findings with intraoperative placental assessment.and obstetrical outcome in both the groups.

Material and methods: 140 antenatal women at ≥34 weeks of gestation were selected ,out of which 70 had the history of previous caesarean section and 70 had the history of previous vaginal delivery. All cases were followed till delivery and their intraoperative assessment done and correlated with obstetrical outcomes. 

Result: With increasing number of previous caesarean section, depth and extent of invasion of placenta increases and Edge to Os Distance (EOD) decreases. 8.5% cases with previous 1 caesarean section, 22.22% cases with previous 2 caesarean section and 50% cases with previous >2 caesarean section had some adherence of placenta. 

Conclusion: Uterine scar increases chances of low implantation of placenta as well as its adherence as compared with unscarred uterus. This risk increases with number of caesarean sections. These high-risk cases of scarred uterus especially those with multiple scars should be subjected to detailed sonographic scan by expert radiologist with special focus on placental and retroplacental area.

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