Risks Associated with Cesarean Sections in Women with Placenta Previa

Takayama, Tetsuji; Minakami, Hisanori; Koike, Tomoyuki; Watanabe, Takashi; Sato, Ikuo

doi:10.1111/j.1447-0756.1997.tb00861.x

Cited by 15 publications

(9 citation statements)

References 10 publications

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“…With regard to maternal outcomes, we also demonstrated that recurrent or major APH enhanced hospitalizations, led to maternal anemia, and increased emergent CDs, blood transfusion rate, and total blood-product infusion; these ndings were also con rmed by Takayama 24 and Crane et al 25 Although these authors also reported that APH elevated rates of hysterectomy 24 and PPH, 25,26 we did not nd an increase in bleeding with hysterectomy or PPH in our study. We additionally treated our hysterectomy or PPH patients with various hemostatic methods including uterine balloons, B-Lynch sutures, arterial ligation, or bilateral uterine artery embolization.…”

Section: Discussionsupporting

confidence: 78%

Influence of antepartum hemorrhage on placenta previa: A multi-center, retrospective cohort study

Qing¹,

Li²,

Venna³

et al. 2020

Preprint

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BACKGROUND Placenta previa can be a serious, life-threatening obstetric complication that causes painless but potentially catastrophic bleeding. It is unclear as to whether the frequency of antepartum hemorrhage (APH) relative to the specific gestational week in placenta previa will lead to negative perinatal outcomes. The purpose of the present study was to determine the relationship between APH and gestational week number, and to ascertain the different perinatal outcomes in women with placenta previa. METHODS This was a multi-center, retrospective study in which we enrolled all women with placenta previa between October of 2015 and September of 2018. Patients with placenta previa were divided into two groups: women with APH and women without APH. RESULTS A total of 247 patients were included in this study: 121 women with APH and 126 women without. The incidence of APH was 49.0% (121/247). The mean bleeding frequency was 2.2 ± 1.3 (mean ± SD), with the majority having experienced a one-time bleeding episode (36.4%, 44/121), followed by 26.4% with 2 episodes (32/121), and 23.1% with 3 (28/121). The APH was distinct in every gestational-week category, with bleeding occurring at 31.4 ± 3.3 weeks, ranging from 24 to 37 gestational weeks. The incidence of bleeding varied from 2.6–14.6%, with the highest incidence at 32 gestational weeks. Patients categorized as having complete placental coverage included a greater number of women experiencing bleeding than women who did not bleed (72.9% vs 47.4%, P < 0.001), indicating that a complete placenta was an independent risk factor for APH (odds rations [OR], 4.17; 95% confidence interval [CI], 1.805–9.634). In addition, although APH did not augment the rates of hysterectomy (6.6% vs 7.1%, P = 0.869), it was associated with critical neonatal outcomes that included lower weight, lower Apgar score at 1 minute, preterm age, and more frequent neonatal intensive care unit admissions (P < 0.05). CONCLUSIONS The gestational week and frequency of each APH varied in patients with placenta previa and might result in an increase in adverse maternal and neonatal outcomes. The 32nd gestational week appeared to be the most precarious time—exhibiting the highest incidence of bleeding—and we consider complete placenta previa to be an independent risk factor for APH.

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Section: Discussionsupporting

confidence: 78%

Influence of antepartum hemorrhage on placenta previa: A multi-center, retrospective cohort study

Qing¹,

Li²,

Venna³

et al. 2020

Preprint

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“…Cesarean delivery is necessary in practically all cases of placenta previa. The volume of hemorrhage during surgery in cases of placenta previa is significantly higher than in cases of normal placental presentation, and the rate of blood transfusion is also significantly increased . Different traditional methods should be used to stop hemorrhaging, including sustained uterine massage, uterine packing, and uterotonic agents, such as oxytocin, ergometrine and prostaglandin.…”

Section: Introductionmentioning

confidence: 99%

“…The volume of hemorrhage during surgery in cases of placenta previa is significantly higher than in cases of normal placental presentation, and the rate of blood transfusion is also significantly increased. 5 Different traditional methods should be used to stop hemorrhaging, including sustained uterine massage, uterine packing, and uterotonic agents, such as oxytocin, ergometrine and prostaglandin. However, during cesarean section in patients with placenta previa, hemorrhage from the placental implantation site may continue after placenta delivery because the lower uterine segment has poorer contraction than the uterine body.…”

Section: Introductionmentioning

confidence: 99%

Local injection of vasopressin reduces the blood loss during cesarean section in placenta previa

Kato

Tanabe

Kanki

et al. 2014

J of Obstet and Gynaecol

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“…Placenta previa has been well documented to be associated with adverse maternal outcomes as well as neonatal outcomes [2]. Studies reported that 5% of obstetric hysterectomies were due to placenta previa [3,4]. The need for urgent hysterectomy recently has changed from drawbacks of atony of the uterus to abnormal location of the placenta that has now became a more common indication due to increased number of pregnancies with previous caesarean scar.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Pregnancy Outcomes in Relation to Placenta Previa Location

Ibrahim¹,

Am²,

Ms³

2018

Gynecol Obstet

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Aim: To evaluate the effect of the type and site of placenta previa on pregnancy outcomes. Methods: We studied retrospectively 324 women with singleton pregnancies presented with placenta previa. After diagnosis by trans abdominal U/S, the cases were grouped into complete and incomplete placenta previa, and then each were categorized to posterior and anterior groups. We compared maternal criteria and outcomes of neonates in complete and incomplete placentae previa, and the differences between the two groups were evaluated. Results: Women with complete placenta previa were more prevalent than those with incomplete placenta previa (59.2% versus 17.5%), with the higher incidence of preterm labor in women with complete than in those with incomplete placenta previa (45.2% versus 8.7%); Incidence of APH in complete placenta previa did not significantly differ between the posterior and the anterior groups. The anterior group was with higher incidence of preterm labor than the posterior group (76.3% versus 31.9%; p=0.002). Gestational age at labor with incomplete placenta previa didn't significantly differ between the posterior and anterior groups. Conclusion: Awareness should be taken towards the risk of increased maternal and fetal morbidity, especially with anterior placenta previa.

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Risks Associated with Cesarean Sections in Women with Placenta Previa

Abstract: Cesarean section in the women with placenta previa was associated with increased blood loss, resulting in a blood transfusion rate 6.5 times higher than in the control subjects. These findings suggest that placenta previa might adversely affect the neonatal outcome.

Cited by 15 publications

References 10 publications

Influence of antepartum hemorrhage on placenta previa: A multi-center, retrospective cohort study

Influence of antepartum hemorrhage on placenta previa: A multi-center, retrospective cohort study

Local injection of vasopressin reduces the blood loss during cesarean section in placenta previa

Evaluation of Pregnancy Outcomes in Relation to Placenta Previa Location

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