The comparison of maternal and neonatal outcomes between emergency and planned cesarean deliveries in women with placenta previa
Objectives: To compare maternal and neonatal outcomes concerning emergency or planned cesarean deliveries in pregnancies complicated by placenta previa (PP), and to evaluate factors related to blood transfusion requirement. Methods: Three hundred sixty-three women with PP with (n = 80) and without (n = 283) placenta accreta spectrum (PAS) who delivered between May 2016 and May 2021 were retrospectively reviewed. The patients were allocated to two main groups as PAS and non-PAS and into two subgroups as emergency cesarean delivery (ECD) and planned cesarean delivery (PCD). Results: One hundred twenty-eight deliveries were emergency and 155 were planned in non-PAS group. In PAS group 38 patients were delivered urgently and 42 were delivered as planned. General anesthesia was preferred more frequently in emergency cases. Gestational age, birth weight, and the 1st and 5th minute APGAR scores of the infants were significantly lower and neonatal intensive care unit (ICU) admission was significantly higher in the ECD cases (p < 0.001) in both PAS and non-PAS groups. The total amount of blood and blood product transfused (p = 0.005), length of hospital stay (p = 0.022) were higher in the ECD cases and adult ICU admission was significantly higher in the ECD cases in non-PAS group (p = 0.016). In multilinear regression analysis, the need for blood transfusion was found to increase with the number of previous cesarean sections, ECD, PP with PAS, general anesthesia, and uterine artery ligation. Conclusions: In placenta previa, which is an obstetric condition associated with serious maternal and neonatal morbidity and mortality, adverse maternal and neonatal outcomes increase in cases of emergency cesarean delivery.
Keywords:
Planned cesarean delivery emergency cesarean delivery, hysterectomy, placenta previa, placenta accreta spectrum, blood transfusion,
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- 1. Reddy UM, Abuhamad AZ, Levine D, Saade GR; Fetal Imaging Workshop Invited Participants. Fetal imaging: Executive summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Institute of Ultrasound in Medicine, American College of Obstetricians and Gynecologists, American College of Radiology, Society for Pediatric Radiology, and Society of Radiologists in Ultrasound Fetal Imaging Workshop. J Ultrasound Med 2014;33:745-57.
- 2. 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;10:414-9.
- 3. Jauniaux E, Grønbeck L, Bunce C, Langhoff-Roos J, Collins SL. Epidemiology of placenta previa accreta: a systematic review and meta-analysis. BMJ Open 2019;9:e031193.
- 4. Getahun D, Oyelese Y, Salihu HM, Ananth CV. Previous cesarean delivery and risks of placenta previa and placental abruption. Obstet Gynecol 2006;107:771-8.
- 5. Korosec S, Ban Frangez H, Verdenik I, Kladnik U, Kotar V, Virant-Klun I, et al. Singleton pregnancy outcomes after in vitro fertilization with fresh or frozen-thawed embryo transfer and incidence of placenta praevia. Biomed Res Int 2014;2014:431797
- 6. Kumru P, Demirci O, Erdogdu E, Arısoy R, Ertekin AA, Tugrul S, et al. The Bakri balloon for the management of postpartum hemorrhage in cases with placenta previa. Eur J Obstet Gynecol Reprod Biol 2013;167:167-70.
- 7. Tantbirojn P, Crum CP, Parast MM. Pathophysiology of placenta creta: the role of decidua and extravillous trophoblast. Placenta 2008;29:639-45.
- 8. Vahanian SA, Lavery JA, Ananth CV, Vintzileos A. Placental implantation abnormalities and risk of preterm delivery: a systematic review and metaanalysis. Am J Obstet Gynecol 2015; 213:S78-90.
- 9. Salihu HM, Li Q, Rouse DJ, Alexander GR. Placenta previa: neonatal death after live births in the United States. Am J Obstet Gynecol 2003; 188:1305-9.
- 10. ACOG Committee Opinion No. 764: medically indicated late-preterm and early-term deliveries. Obstet Gynecol 2019;133:e151-5.
- 11. Karaca Ü, Özgünay ÖŞ, Ata F, Kılıçarslan N, Yılmaz C, Karasu D. [Our experiences of anesthesia in emergency cesarean sections]. JARSS 2020;28:275-80. [Article in Turkish]
- 12. Levin G, Rottenstreich A, Ilan H, Cahan T, Tsur A, Meyer R. Predictors of adverse neonatal outcome in pregnancies complicated by placenta previa. Placenta 2021;104:119-23.
- 13. Asıcıoglu O, Şahbaz A, Güngördük K, Yildirim G, Asıcıoglu BB, Ülker V. Maternal and perinatal outcomes in women with placenta praevia and accreta in teaching hospitals in Western Turkey. J Obstet Gynaecol 2014;34:462-6.
- 14. Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA, et al. Maternal morbidity associated with multiple repeat cesarean deliveries, Obstet. Gynecol 2006;107:1226-32.
- 15. Ananth CV, Wilcox AJ, Savitz DA, Bowes WA Jr, Luther ER. Effect of maternal age and parity on the risk of uteroplacental bleeding disorders in pregnancy. Obstet Gynecol 1996;88:511-6
- 16. Batmaz G, Molla F, Molla T, Özcan P, Dansuk R, Dane B. [Retrospective analysis of patients with placenta previa]. Med Bull Haseki 2015;53:299-302. [Article in Turkish]
- 17. Tuzovic L, Djelmis J, Ilijic M. Obstetric risk factors associated with placenta previa development: Case-control study. Croat Med J 2003;44:728-33.
- 18. Zlatnik MG, Little SE, Kohli P, Kaimal AJ, Stotland NE, Caughey AB. When should women with placenta previa be delivered? A decision analysis. J Reprod Med 2010;55:373-81.
- 19. Erfani H, Kassir E, Fox KA, Clark SL, Karbasian N, Salmanian B, et al. Placenta previa without morbidly adherent placenta: comparison of characteristics and outcomes between planned and emergent deliveries in a tertiary center. J Matern Fetal Neonatal Med 2019;32:906-9.
- 20. Ruiter L, Eschbach SJ, Burgers M, Rengerink KO, van Pampus MG, van der Goes BY, et al. Predictors for emergency cesarean delivery in women with placenta previa. Am J Perinatol 2016;33:1407-14.
- 21. Durukan H, Durukan ÖB, Yazıcı FG. Planned versus urgent deliveries in placenta previa: maternal, surgical and neonatal results. Arch Gynecol Obstet 2019;300:1541-9.
- 22. Rosenberg T, Pariente G, Sergienko R, Wiznitzer A, Sheiner E. Critical analysis of risk factors and outcome of placenta previa. Arch Gynecol Obstet 2011;284:47-51.
- 23. Titapant V, Chongsomboonsuk T. Associated factors of blood transfusion for caesarean sections in pure placenta praevia pregnancies. Singapore Med J 2019;60:409-13.
- ISSN: 2149-3189
- Yayın Aralığı: Yılda 6 Sayı
- Başlangıç: 2015
- Yayıncı: Prusa Medikal Yayıncılık Limited Şirketi
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