Risk Factors for Peripartum Blood Transfusion in Women with Placenta Previa: A Retrospective Analysis

Objective: To evaluate the maternal and foetal outcome in cases of placenta previa, placenta accrete and placenta increta. Methods: Medical records of patients from 1 Feb 2014 to 28 Feb 2015 were checked and patients who underwent caesarean section with a diagnosis of placenta previa types III and IV (and placenta accreta, increta and percreta) were identified. Their medical record files were retrieved and data collected regarding patients age, parity, previous LSCS, D&C, blood loss, bladder injury, hysterectomy and use of B-lynch technique were recorded. Neonatal statistics were also recorded regarding birth weight, gender, APGAR score and need for admission in NICU. Results: In total 37 cases of major placenta previa were identified. These included 8 cases with placenta accrete including 2 cases of placenta increta. No maternal death occurred amongst the studied cases. Only one case of IUFD was identified. The incidence of placenta previa (major) was 29.95/1000 births. Average parity of patients with placenta accreta (PA) was significantly higher than cases of placenta previa (PP) (2.75 vs. 1.55, p = 0.04). Similarly average number of LSCS in cases of PA was significantly higher than cases of PP (2.25 vs. 0.86, p = 0.02). PA cases were delivered at a significantly earlier gestational age as compared to cases with PP (34.5 weeks vs. 37 weeks, p = 0.01). Hysterectomy was done in 6 (75%) cases of PA but in none with PP. Bladder injury occurred in 2(25%) cases of PA but in none with PP. Blood loss was also significantly higher in PA cases than PP cases (3975 ml vs. 1196 ml, p = 0.006). Conclusion: At tertiary care hospitals, maternal and foetal outcomes for placenta previa and placenta accreta have improved owing to improved surgical techniques and better understanding of these conditions.

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“…9,10 Average blood loss in present study (1196 ml) is lower than these earlier studies again reflecting an improvement in maternal outcomes.…”

Section: Discussioncontrasting

confidence: 52%

Maternal and Foetal Outcome in Cases of Placenta Previa, Accreta and Increta

Anjum¹,

Bashir²,

Rahim³

2016

Annals KEMU

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“…Twenty-five retrospective and four prospective cohort studies involving a total of 4687 individuals were included in the study (Table 1). Fourteen1516171819202122232425262728 took place in Asia, eight529303132333435 in North America, six101136373839 in Europe, and one40 in Africa. The articles were published between 1985 and 2016, and the median number of participants per study was 162 (range, 40–703).…”

Section: Resultsmentioning

confidence: 99%

Prevalence of antepartum hemorrhage in women with placenta previa: a systematic review and meta-analysis

Fan

Liu

et al. 2017

Sci Rep

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Antepartum hemorrhage (APH) is an important cause of perinatal mortality and maternal morbidity in pregnant women with placenta previa in the world. However, the epidemiological characteristics are not completely understood. We performed an initial systematic review and meta-analysis to assess the prevalence of APH in pregnant women with placenta previa. It was totally performed following the Preferred Reporting Items for Systematic reviews and Meta-Analysis statement. PubMed, Elsevier Science Direct, and the Cochrane Library were searched before April 2016. A meta-analysis with a random-effects model based on a proportions approach was performed to determine the prevalence. Stratified analyses, meta-regression method, and sensitivity analysis were utilized to analyze the heterogeneity. A total of 29 articles were included. The pooled overall prevalence of APH among pregnant women with placenta previa was 51.6% (95% CI 42.7–60.6) in a heterogeneous set of studies (I2 = 97.9). Correlation analysis found that there was a positive correlation between prevalence and percentage of multiparous (r = 0.534, P = 0.027) and a negative correlation between prevalence and survey year (r = −0.400, P = 0.031). In conclusion, the prevalence of APH was a high condition among pregnant women with placenta previa.

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“…They are accounted as risk factors of excessive bleeding and peripartum hysterectomy, even if placenta previa does not exist 3,6,9. Therefore Faiz et al .…”

Section: Discussionmentioning

confidence: 99%

Maternal Outcomes According to Placental Position in Placental Previa

Jang¹,

We²,

Shin³

et al. 2011

Int. J. Med. Sci.

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Purpose: The purpose of this retrospective cohort study was to elucidate whether the location of placenta below uterine incision in cesarean section is important in the development of maternal complications in placenta previa patients.Methods: The study was conducted on 409 patients 414 parturition at 3 hospitals in affiliation with the Catholic Medical Center, Seoul, Korea from May 1999 to December 2009. The subjects were divided to two groups: the group whose placenta was located in the anterior portion of the uterus (anterior group) and the group whose placenta was located in the posterior portion of the uterus (posterior group). And then they are compared to each other. Logistic regression was used to control for confounding factors.Results: In the anterior group, regardless of confounding factors, the incidence of excessive blood loss (OR 2.97; 95% CI: 1.64-5.37), massive transfusion (OR 3.31; 95% CI: 1.33-8.26), placental accreta (OR 2.60, 95% CI: 1.40-4.83), and hysterectomy (OR 3.47, 95% CI: 1.39-8.68) was higher.Conclusion: Sonographic determination of the placental position where its location beneath the uterine incision is very important to predict maternal outcomes in placenta previa patients, and such cases, close attention should be paid for massive hemorrhage.

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Risk Factors for Peripartum Blood Transfusion in Women with Placenta Previa: A Retrospective Analysis

Cited by 28 publications

References 15 publications

Maternal and Foetal Outcome in Cases of Placenta Previa, Accreta and Increta

Maternal and Foetal Outcome in Cases of Placenta Previa, Accreta and Increta

Prevalence of antepartum hemorrhage in women with placenta previa: a systematic review and meta-analysis

Maternal Outcomes According to Placental Position in Placental Previa

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