Effect of types of placenta previa on maternal and neonatal outcomes: a 10-year retrospective cohort study

Abstract

Purpose: Through this study, we aimed to evaluate the effects of different types of placenta previa (PP) on maternal and neonatal outcomes.Methods: This study was conducted in The Third A liated Hospital of Guangzhou Medical University and Tongji Hospital between January 2009 and 2019. PP was traditionally classi ed into four types, namely low-lying placenta, marginal, partial, and complete PP. Previous studies have classi ed PP into two types, namely low-lying placenta and PP. Based on our clinical experience, we proposed the classi cation of PP into three types, for the rst time, which included low-lying placenta, "marpartial" (marginal and partial) PP, and complete PP. Multivariate logistic regression analysis was performed to determine the effects of different types of PP on maternal and neonatal outcomes.Results: In total, 4490 singleton pregnancies were complicated with PP. In the four-classi cation method, compared with women with low-lying placenta, women with complete PP had a risk of placenta accrete spectrum disorders, postpartum hemorrhage (PPH), hemorrhagic shock, severe PPH, blood transfusion, hysterectomy, puerperal infection, preterm labor, NICU admission, and low birth weight. There was no difference in maternal and neonatal outcomes between marginal and partial PP, except for increased chances of preterm labor and low birth weight in partial PP. In the two-classi cation method, PP was the risk factor for most of the adverse maternal and neonatal outcomes, compared with low-lying placenta. Conclusion:Complete PP and low-lying placenta were associated with the highest and lowest risks of adverse pregnancy outcomes, respectively, whereas clinically similar outcomes were observed between marginal and partial PP. The three-classi cation of PP may be practical from the clinical perspective.

Association of Placenta Previa With Severe Maternal Morbidity Among Patients With Placenta Accreta Spectrum Disorder

“…5,10,[13][14][15][16][17] Placenta previa is a major risk factor for PAS, 18,19 and placenta previa itself is a severe pregnancy complication that can lead to substantial postpartum hemorrhage and organ injuries. 20 According to a cohort study of 605 362 deliveries in Nordic countries, the estimated prevalence of PAS among those with placenta previa (41.8 cases per thousand) was higher than that of all pregnancies (0.3 cases per thousand) or pregnancies with previous cesarean delivery (8.8 cases per thousand among those with 3 previous cesarean deliveries). 19,21 Therefore, multiple guidelines 16,22,23 have recommended that patients with a diagnosis of placenta previa be screened vigorously for placental adherence using multimodal ultrasonographic and magnetic resonance imaging.…”

“…Placenta previa is a major risk factor for PAS, and placenta previa itself is a severe pregnancy complication that can lead to substantial postpartum hemorrhage and organ injuries . According to a cohort study of 605 362 deliveries in Nordic countries, the estimated prevalence of PAS among those with placenta previa (41.8 cases per thousand) was higher than that of all pregnancies (0.3 cases per thousand) or pregnancies with previous cesarean delivery (8.8 cases per thousand among those with 3 previous cesarean deliveries) .…”

Desenlaces maternos según el tipo de placenta previa en un hospital de alta complejidad en Cali, Colombia. Estudio de cohorte retrospectivo

“…Ninguna mujer tuvo daño vesical durante la cesárea y no se encontraron muertes maternas en este estudio (Tabla 3). Respecto a la frecuencia en la realización de histerectomía y requerimiento de admisión en UCI, nuestros hallazgos son consistentes con lo descrito en la literatura (21).…”

Blood Type and Outcomes in Pregnant Women with Placenta Previa

“…Placenta previa is defined as the placenta overlying the endocervical os and is characterized as complete, partial, marginal, and low-lying placenta depending on how much of the internal endocervical os is covered by the placenta [ 1 , 2 ]. The incidence is estimated to be 5 to 12 per 1000 deliveries and varies throughout the world [ 3 , 4 ].…”

“…Cesarean delivery has been confirmed as an independent risk factor for placenta previa. The other relevant risk factors included advanced maternal age, previous uterine surgery (endometrial ablation, dilatation and curettage, myomectomy, and hysteroscopic removal of intrauterine adhesions), assisted reproductive technology pregnancies, multiparity, excessive weight gain during pregnancy, and cigarette smoking [ 2 , 9 , 10 ].…”