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Impact of Placenta Previa on Obstetric Outcome

Year 2014, Volume: 11 Issue: 1, 6 - 8, 01.01.2014

Abstract

Aim: To determine the incidence and clinical and operative characteristics of placenta previa PP and impact of placenta previa on obstetric outcome. Material and Methods: Eightyeight patients with placenta previa were evaluated from 32945 of pregnancies at the Obstetrics Department of a Tertiary Research and Education Hospital between December 2010 and June 2013. Demographic characteristics, types of placenta previa locations, neonatal weight,fetal sex,Apgar scores of 5th minutes and numbers of previous cesarean sections were recorded. Results: The incidence of PP in the present study was 0.26 %. The mean age of patients with placenta previa was 31.08 years old range 23-42 years , gestational week 35.45±3.19 25-40 , gravidity 3.19± 1.84 1-11 and parity was 1.51± 1.49 0-10 . There were 60 68.2% women with complete placenta previa, 21 23.9% with incomplete placenta previa,3 3.4% with marginal placenta previa,4 4.5% with a low lying placenta. Overall, 11 12.5% patients underwent obstetric hysterectomy. The majority of women 10 of 11 women 90.9%with an obstetric hysterectomy had complete PP. The mean neonatal weight was 2680 g range 650-4220g ,the fifth minutes Apgar scores were found as 8.16 ±1.72 0-9 . Among the 88 delivered neonates, 45 51.1% were male and 43 48.9% were female. Conclusion: The risk of adverse maternal and neonatal outcome in PP pregnancies increases with an increasing number of previous cesarean deliveries. It should be kept in mind that cases of PP especially with previous cesarean sections have high probability of emergency peripartum hysterectomy. When placenta previa suspected or diagnosed during antenatal follow up,the patient must be referred to a tertiary center and the delivery should be performed in suitable clinical settings with experienced surgeons.

References

  • 1. Oyelese Y, Smulian JC. Placenta previa, placenta accreata, and vasa previa. Obstet Gynecol 2006;107:927–41.
  • 2. Kastner ES, Figueroa R, Garry D, Maulik D. Emergency peripartum hysterectomy:experience at a community teaching hospital. Obstet Gynecol 2002;99:971–5.
  • 3. CigerliE, Saygılı H. Placenta previa: comparison of the outcomes of cases managed with planned cesarean section versus emergency cesarean section.J Ist Faculty Med 2005;68: 93-96.
  • 4. Daskalakis G, Simou M, Zacharakis D, Detorakis S, Akrivos N, Papantoniou N,Fouskakis T, Antsaklis A. Impact of placenta previa on obstetric outcome.Int Journal of Gynecology and Obstetrics 2011;114:238-241.
  • 5. Singh PM, Rodrigues C, Gupta AN. Placenta previa and previous cesarean section. Acta Obstet Gynecol Scand 1981;60:367–8.
  • 6. Faiz AS, Ananth CV. Etiology and risk factors for placenta previa: an overview andmeta-analysis of observational studies. J Matern Fetal Neonatal Med 2003;13:175–90.
  • 7. Dola CP, Garite TJ, Dowling DD, Friend D, Ahdoot D, Asrat T.Placenta previa: doesits type affect pregnancy outcome? Am J Perinatol 2003;20:353–60.
  • 8. Tuzovic L. Complete versus incomplete placenta previa and obstetric outcome. Int J Gynecol Obstet 2006;93:110–7.
  • 9. Rasmussen S,Albrechtsen S, Llaker K. Obstetric history and the risk of placentaprevia.Acta Obstet Gynecol Scand 2000; 79: 502–507
  • 10. Brenner WE, Edelman DA, Hendricks CH. Characteristics of patients with placenta previa and results of ‘expectant management’. Am J Obstet Gynecol 1978; 132: 180–91
  • 11. Crane JM, Van den Hof MC, Dodds L, Armson BA, Liston R.Maternal complications with placenta previa. Am J Perinatol2000; 17:101–105
  • 12. Sheiner E, Shoham-Vardi I, Hallak M, Hershkowitz R, Katz M,Mazor M.Placenta previa: obstetric risk factors and pregnancy outcome. J Matern Fetal Med 2001; 10:414–419
  • 13. Ananth CV, Smulian JC, Vintzileos AM .The effect of placenta previa on neonatal mortality: a population-based study in the United States, 1989 through 1997. Am J Obstet Gynecol 2003;188:1299– 1304 14. Salihu HM, Li Q, Rouse DJ, Alexander GR.Placenta previa: neonatal death after live births in the United States. Am J Obstet Gynecol 2003; 188:1305–1309
  • 15. Evsen MS, Sak ME, Soydinc HE ,Caca FN, Obut M, Gül T.Retrospective analysis of placenta accreata:managment strategies-evaluation of 41 cases.Ginekol Pol 2012;83,501-504.
  • 16. Grobman WA, Gersnoviez R, Landon MB, Spong CY, Leveno KJ, Rouse DJ.Pregnancy outcomes for women with placenta previa in relation to the number ofprior cesarean deliveries. Obstet Gynecol 2007;110:1249–55.
  • 17. Yaegashi N, Chiba-Sekii A, Okamura K. Emergency postpartum hysterectomy inwomen with placenta previa and prior cesarean section. Int J Gynecol Obstet 2000; 68:49–52.
  • 18. Rosenberg T , Pariente G , Sergienko R, WiznitzerA, Sheine E. Critical analysis of risk factors and outcome of placenta previa. Arch Gynecol Obstet 2011; 284:47–51
  • 19. Clark S,Koonings P,Phelan J.Placenta previa/accreata and prior cesarean section Obstetric Gynecol 1985;66,89-92.
  • 20. Gielchinsky Y,Rojansky N,FasouliotisS,Ezra Y.Placenta accreata:summary of 10 years: a survey of 310 cases.Placenta 2002;23,210-214.
  • 21. Choi SJ, Song SE, Jung KL, Oh SY, Kim JH, Roh CR. Antepartum risk factors associated with peripartum cesarean hysterectomy in women with placenta previa. Am J Perinatol 2008;25:37–41.
  • 22. Ananth CV, Demissie K, Smulian JC, Vintzileos AM. Relationship among placentaprevia, fetal growth restriction, and preterm delivery: a population-based study. Obstet Gynecol 2001;98:299–306.
  • 23. Zlatnik MG, Cheng YW, Norton ME, Thiet MP, Caughey AB. Placenta previa and therisk of preterm delivery. J Matern Fetal Neonatal Med 2007;20:719–23

Plasenta Previanın Obstetrik Sonuçlar Üzerine Etkisi

Year 2014, Volume: 11 Issue: 1, 6 - 8, 01.01.2014

Abstract

Amaç: Plasenta previa olgularının insidansını, klinik ve operatif özelliklerini incelemek ve gebelik sonuçları üzerine etkisini değerlendirmek.Gereç ve yöntem: Kliniğimizde 2011 Aralık ve 2013 Haziran tarihleri arasında doğumu gerçekleşmiş 32945 gebelikten 88 plasenta previa PP olgusu retrospektif olarak incelendi. Olguların demografik özellikleri,plasenta yerleşim tipleri,fetal doğum ağırlığı ve cinsiyeti, 5. dakika apgar skoru ve daha önce geçirmiş olduğu sezaryen sayısı kaydedildi. Bulgular: Çalışmamızda PP insidansı %0.26, bu olgularda ortalama yaş 31.08 ±5.12 23-42 , gebelik haftası 35.45±3.19 25-40 , gravida 3.19± 1.84 1-11 , parite 1.51± 1.49 0-10 olarak bulundu.Plasenta previa olgularının%68.2’si komplet,%23.9’u inkomplet, %3.4’ü marjinal,%4.5’i alt segmentyerleşimliydi. Plasenta previa olgularının %12.5’ine kanama kontolünü sağlamak için histerektomi yapıldı. Histerektomi yapılan vakaların %90,9’unda plasenta komplet yerleşimliydi ve hepsinin geçirilmiş sezaryen öyküsü vardı. Ortalama yenidoğan ağırlığı 2680± 913g 650-4250 ,ortalama 5. dakika apgar skoru 8.16 ±1.72 0-9 olarak bulundu ve fetusların %51,1’i erkek %48,9’u kız idi. Sonuç: Plasenta previa olgularında daha önce geçirilmiş sezaryen sayısında artış olması, gerek anne gerekse yenidoğanaçısından aşırı kanama ve prematüritede artış şeklinde olumsuz sonuçları beraberinde getirmektedir.Plasenta previa olgularında özellikle komplet yerleşimli ve daha önce sezaryen öyküsü olan hastalara acil peripartumhisterektomi yapılma ihtimali daha yüksektir.Sezaryen histerektomimorbiditesi yüksek bir operasyondur, bu nedenle plasenta previadan şüphelenildiğinde veya antenatal olarak tanı konulduğunda tersiyer merkezlerde ve tecrübeli bir ekip tarafından ve iyi planlanmış bir şekilde gerçekleştirilmelidir.

References

  • 1. Oyelese Y, Smulian JC. Placenta previa, placenta accreata, and vasa previa. Obstet Gynecol 2006;107:927–41.
  • 2. Kastner ES, Figueroa R, Garry D, Maulik D. Emergency peripartum hysterectomy:experience at a community teaching hospital. Obstet Gynecol 2002;99:971–5.
  • 3. CigerliE, Saygılı H. Placenta previa: comparison of the outcomes of cases managed with planned cesarean section versus emergency cesarean section.J Ist Faculty Med 2005;68: 93-96.
  • 4. Daskalakis G, Simou M, Zacharakis D, Detorakis S, Akrivos N, Papantoniou N,Fouskakis T, Antsaklis A. Impact of placenta previa on obstetric outcome.Int Journal of Gynecology and Obstetrics 2011;114:238-241.
  • 5. Singh PM, Rodrigues C, Gupta AN. Placenta previa and previous cesarean section. Acta Obstet Gynecol Scand 1981;60:367–8.
  • 6. Faiz AS, Ananth CV. Etiology and risk factors for placenta previa: an overview andmeta-analysis of observational studies. J Matern Fetal Neonatal Med 2003;13:175–90.
  • 7. Dola CP, Garite TJ, Dowling DD, Friend D, Ahdoot D, Asrat T.Placenta previa: doesits type affect pregnancy outcome? Am J Perinatol 2003;20:353–60.
  • 8. Tuzovic L. Complete versus incomplete placenta previa and obstetric outcome. Int J Gynecol Obstet 2006;93:110–7.
  • 9. Rasmussen S,Albrechtsen S, Llaker K. Obstetric history and the risk of placentaprevia.Acta Obstet Gynecol Scand 2000; 79: 502–507
  • 10. Brenner WE, Edelman DA, Hendricks CH. Characteristics of patients with placenta previa and results of ‘expectant management’. Am J Obstet Gynecol 1978; 132: 180–91
  • 11. Crane JM, Van den Hof MC, Dodds L, Armson BA, Liston R.Maternal complications with placenta previa. Am J Perinatol2000; 17:101–105
  • 12. Sheiner E, Shoham-Vardi I, Hallak M, Hershkowitz R, Katz M,Mazor M.Placenta previa: obstetric risk factors and pregnancy outcome. J Matern Fetal Med 2001; 10:414–419
  • 13. Ananth CV, Smulian JC, Vintzileos AM .The effect of placenta previa on neonatal mortality: a population-based study in the United States, 1989 through 1997. Am J Obstet Gynecol 2003;188:1299– 1304 14. Salihu HM, Li Q, Rouse DJ, Alexander GR.Placenta previa: neonatal death after live births in the United States. Am J Obstet Gynecol 2003; 188:1305–1309
  • 15. Evsen MS, Sak ME, Soydinc HE ,Caca FN, Obut M, Gül T.Retrospective analysis of placenta accreata:managment strategies-evaluation of 41 cases.Ginekol Pol 2012;83,501-504.
  • 16. Grobman WA, Gersnoviez R, Landon MB, Spong CY, Leveno KJ, Rouse DJ.Pregnancy outcomes for women with placenta previa in relation to the number ofprior cesarean deliveries. Obstet Gynecol 2007;110:1249–55.
  • 17. Yaegashi N, Chiba-Sekii A, Okamura K. Emergency postpartum hysterectomy inwomen with placenta previa and prior cesarean section. Int J Gynecol Obstet 2000; 68:49–52.
  • 18. Rosenberg T , Pariente G , Sergienko R, WiznitzerA, Sheine E. Critical analysis of risk factors and outcome of placenta previa. Arch Gynecol Obstet 2011; 284:47–51
  • 19. Clark S,Koonings P,Phelan J.Placenta previa/accreata and prior cesarean section Obstetric Gynecol 1985;66,89-92.
  • 20. Gielchinsky Y,Rojansky N,FasouliotisS,Ezra Y.Placenta accreata:summary of 10 years: a survey of 310 cases.Placenta 2002;23,210-214.
  • 21. Choi SJ, Song SE, Jung KL, Oh SY, Kim JH, Roh CR. Antepartum risk factors associated with peripartum cesarean hysterectomy in women with placenta previa. Am J Perinatol 2008;25:37–41.
  • 22. Ananth CV, Demissie K, Smulian JC, Vintzileos AM. Relationship among placentaprevia, fetal growth restriction, and preterm delivery: a population-based study. Obstet Gynecol 2001;98:299–306.
  • 23. Zlatnik MG, Cheng YW, Norton ME, Thiet MP, Caughey AB. Placenta previa and therisk of preterm delivery. J Matern Fetal Neonatal Med 2007;20:719–23
There are 22 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Runa Özelçi

Berna Dilbaz This is me

Derya Akdağ Cırık This is me

Tuğba Zengin This is me

Pervin Demir This is me

Publication Date January 1, 2014
Published in Issue Year 2014 Volume: 11 Issue: 1

Cite

Vancouver Özelçi R, Dilbaz B, Akdağ Cırık D, Zengin T, Demir P. Plasenta Previanın Obstetrik Sonuçlar Üzerine Etkisi. JGON. 2014;11(1):6-8.