Conservative management of placenta previa: A cost-benefit analysis

D'Angelo, Larry J.; Irwin, Linda F.

doi:10.1016/0002-9378(84)90232-1

Cited by 40 publications

(8 citation statements)

References 6 publications

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“…The observed incidence of placenta praevia of 0.4% in our study is in keeping with current literature 1,2 , and our data objectively confirm the perception that the clinical course of women with a placenta praevia is unpredictable. The degree of praevia was not predictive of the likelihood of bleeding which, while contrary to common opinion 6 , supports previous findings 10 .…”

Section: Discussionsupporting

confidence: 92%

Pregnancies complicated by placenta praevia: what is appropriate management?

Love¹,

Wallace

1996

BJOG

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Objective To review the outcome of pregnancies complicated by placenta praevia over a three‐year period (1991–1993) and to describe in detail the antenatal course and the events leading to delivery, assessing retrospectively whether there are clinical features predictive of outcome and whether outpatient management would be reasonable. Design A retrospective review of the case records of women with a pregnancy complicated by placenta praevia. Setting A tertiary referral teaching hospital in Edinburgh. Results There were 15,930 deliveries in the study period. Fifty‐eight women (0.4%) had a placenta praevia in the third trimester, 42 of whom (72%) had at least one episode of bleeding. Overall, 62% of the women had a major praevia with no differences in the grade of praevia between those women who did or did not have bleeding. Both diagnosis and delivery occurred significantly earlier in women with antepartum bleeding than in those without (median gestation at diagnosis 28.6 weeks versus 33.3 weeks (P < 0.01) and at delivery 36.0 weeks versus 37.1 weeks (P= 0.04), respectively). Delivery by emergency caesarean section was more common in women with bleeding (62%versus 38%). An increasing number of bleeding episodes experienced by individuals was not associated with significant differences in outcomes. Rapid emergency delivery for bleeding was necessary for three women, in none of whom could the bleeding have been predicted. Conclusions The clinical outcomes of placenta praevia are highly variable and cannot be predicted confidently from antenatal events. Nonetheless, in the majority of cases with or without bleeding and irrespective of the degree of praevia, outpatient management would appear safe and appropriate.

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Section: Discussionsupporting

confidence: 92%

Pregnancies complicated by placenta praevia: what is appropriate management?

Love¹,

Wallace

1996

BJOG

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“…Most women with asymptomatic previa (no bleeding or contractions) are managed as outpatients. Several, 33,34 but not all, 35 retrospective studies show similar outcomes with outpatient management at lower cost. In contrast, hospitalization is advised in most cases of vaginal bleeding or uterine contractions.…”

Section: Managementmentioning

confidence: 69%

Abnormal Placentation

Silver¹

2015

Obstetrics &Amp; Gynecology

413

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Placental disorders such as placenta previa, placenta accreta, and vasa previa are all associated with vaginal bleeding in the second half of pregnancy. They are also important causes of serious fetal and maternal morbidity and even mortality. Moreover, the rates of previa and accreta are increasing, probably as a result of increasing rates of cesarean delivery, maternal age, and assisted reproductive technology. The routine use of obstetric ultrasonography as well as improving ultrasonographic technology allows for the antenatal diagnosis of these conditions. In turn, antenatal diagnosis facilitates optimal obstetric management. This review emphasizes an evidence-based approach to the clinical management of pregnancies with these conditions as well as highlights important knowledge gaps.

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“…The inpatient management of placenta previa has been reported to have a better outcome than outpatient expectant management. 12 Amniocentesis in the series was carried out in only one case for L/S ratio determination at 33 weeks. This procedure is not routine in our unit.…”

Section: Discussionmentioning

confidence: 99%

Maternal and Neonatal Outcome in Major Placenta Previa

Khashoggi

1995

Ann Saudi Med

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Conservative management of placenta previa: A cost-benefit analysis

Cited by 40 publications

References 6 publications

Pregnancies complicated by placenta praevia: what is appropriate management?

Pregnancies complicated by placenta praevia: what is appropriate management?

Abnormal Placentation

Maternal and Neonatal Outcome in Major Placenta Previa

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