Placenta previa: an outcome-based cohort study in a contemporary obstetric population

Lal, Ann K.; Hibbard, Judith U.

doi:10.1007/s00404-015-3628-y

Cited by 56 publications

(44 citation statements)

References 17 publications

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“…Maternal old age, episodes of antepartum bleeding, fetal non‐cephalic presentation, complete placenta previa, anterior localization of the placenta, placental multiple lacunae (≥4), and uteroplacental hypervascularity were risk factors for massive post‐partum bleeding in our cases. Advanced maternal age is a well‐known risk factor . Also, antepartum bleeding was earlier considered a risk factor associated with post‐partum complications in placenta previa cases.…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that massive post-partum hemorrhage can develop in cases of placenta previa, increasing the risk of maternal and neonatal mortality and morbidity. 1,2 In cases of placenta previa, prediction of post-partum blood loss can improve the outcomes of pregnancy and yield information useful in the preparation and management of surgery, including the need for hospital admission, preservation of blood, and timing of the cesarean section (CS). However, although placenta previa is associated with postpartum hemorrhage, massive post-partum bleeding does not always develop.…”

Section: Introductionmentioning

confidence: 99%

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Scoring model to predict massive post‐partum bleeding in pregnancies with placenta previa: A retrospective cohort study

Lee

Ahn

Kang

et al. 2017

J of Obstet and Gynaecol

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Aim: We aimed to identify factors associated with massive post-partum bleeding in pregnancies with placenta previa and to establish a scoring model to predict post-partum severe bleeding. Methods: A retrospective cohort study was performed in 506 healthy singleton pregnancies with placenta previa from 2006 to 2016. Cases with intraoperative blood loss (≥2000 mL), packed red blood cells transfusion (≥4), uterine artery embolization, or hysterectomy were defined as massive bleeding. After performing multivariable analysis, using the adjusted odds ratios (aOR), we formulated a scoring model. Results: Seventy-three women experienced massive post-partum bleeding (14.4%). After multivariable analysis, seven variables were associated with massive bleeding: maternal old age (≥35 years; aOR 1.79, 95% confidence interval [CI] 1.00-3.20, P = 0.049), antepartum bleeding (aOR 4.76, 95%CI 2.01-11.02, P < 0.001), non-cephalic presentation (aOR 3.41, 95%CI 1.40-8.30, P = 0.007), complete placenta previa (aOR 1.93, 95% CI 1.05-3.54, P = 0.034), anterior placenta (aOR 2.74, 95%CI 1.54-4.89, P = 0.001), multiple lacunae (≥4; aOR 2.77, 95%CI 1.54-4.99, P = 0.001), and uteroplacental hypervascularity (aOR 4.51, 95%CI 2.30-8.83, P < 0.001). We formulated a scoring model including maternal old age (<35: 0, ≥35: 1), antepartum bleeding (no: 0, yes: 2), fetal non-cephalic presentation (no: 0, yes: 2), placenta previa type (incomplete: 0, complete: 1), placenta location (posterior: 0, anterior: 1), uteroplacental hypervascularity (no: 0, yes: 2), and multiple lacunae (no: 0, yes: 1) to predict post-partum massive bleeding. According to our scoring model, a score of 5/10 had a sensitivity of 81% and a specificity of 77% for predicting massive post-partum bleeding. The area under the receiver-operator curve was 0.856 (P < 0.001). The negative predictive value was 95.9%. Conclusion: Our scoring model might provide useful information for prediction of massive post-partum bleeding in pregnancies with placenta previa.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Scoring model to predict massive post‐partum bleeding in pregnancies with placenta previa: A retrospective cohort study

Lee

Ahn

Kang

et al. 2017

J of Obstet and Gynaecol

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“…[New 2018] P A large case-control study found that neonatal morbidities in women with placenta praevia include an increased risk of lower 5-minute Apgar scores, neonatal intensive care unit (NICU) admission, anaemia, respiratory distress syndrome, mechanical ventilation and intraventricular haemorrhage. 64 There is no evidence, however, that neonates born after pregnancies with placenta praevia are more likely to be small for gestational age when compared to non-praevia controls. 65 Evidence The 2016 RCT has found that the administration of betamethasone to women with a singleton pregnancy at risk for late preterm delivery (34 +0 to 36 +5 weeks of gestation) significantly reduces the rate of neonatal respiratory complications.…”

Section: 6mentioning

confidence: 99%

Placenta Praevia and Placenta Accreta: Diagnosis and Management

Jauniaux¹,

Alfirević²,

Bhide³

et al. 2018

BJOG

424

415

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“…In some studies, the increased likelihood of placenta previa has been associated with increased parity at an older maternal age and therefore an increase in previous uterine interventions [8,12]. In 3 cohort studies, advanced maternal age has been reported as the cause of a 1.2-2.7-fold increase in the incidence of placenta previa [13][14][15]. In the current study, advanced maternal age increased the likelihood of placenta previa 2.67-fold.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of placenta previa: a population based study and the review of the literature

Çetin¹,

Yalçın²,

Yalçın³

et al. 2016

Med-Science

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The aim of our study is to provide a population-based risk factor profile for placenta previa and thereby enable early diagnosis plus the necessary management for this risky group. Methods This research was a retrospective case control study including 25105 pregnancies in the period January 2000-December 2010. The data of 25105 pregnancies were examined on the hospital database. A total of 139 single pregnancies complicated by placenta previa were compared with a randomly selected control group of 1200 single pregnancies. Evaluation was made of risk factors for placenta previa. Results Of the 25105 pregnancies presenting at our clinic during the 10-year period, placenta previa was determined in 139, giving an incidence rate of 0.55%. In the comparison of the two groups; advanced maternal age, multiparity, a history of caesarean section, a history of abortion or uterine curettage, cigarette smoking and male gender were found to be statistically significant as a risk factor for placenta previa. Conclusions The knowledge of the predisposing obstetric factors in respect of the development of placenta previa on a population basis provides the possibility of a careful approach on an individual patient basis.

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Placenta previa: an outcome-based cohort study in a contemporary obstetric population

Abstract: Increased maternal morbidity was noted; however, only those neonatal morbidities associated with preterm delivery occurred in the placenta previa group.

Cited by 56 publications

References 17 publications

Scoring model to predict massive post‐partum bleeding in pregnancies with placenta previa: A retrospective cohort study

Scoring model to predict massive post‐partum bleeding in pregnancies with placenta previa: A retrospective cohort study

Placenta Praevia and Placenta Accreta: Diagnosis and Management

Risk factors of placenta previa: a population based study and the review of the literature

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