Does cervical length and the lower placental edge thickness measurement correlates with clinical outcome in cases of complete placenta previa?

Zaitoun, Mohamed; Behery, Manal M. El; Hameed, Azza A. Abd El; Soliman, Badeea S.

doi:10.1007/s00404-010-1737-1

Cited by 41 publications

(48 citation statements)

References 17 publications

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“…A short cervical length of less than 3 cm could predict the risk of antenatal hemorrhage (p=0.004). However, a short cervical length of less than 3 cm had no significant effect on cesarean hysterectomy and peripartum blood transfusion in their study [15]. Shin et al also reported the effect of cervical length on placenta previa.…”

Section: Resultsmentioning

confidence: 69%

“…Therefore, sonographic findings predicting preterm labor may be more meaningful for antenatal hemorrhage than sonographic findings predicting placental adhesion. Thus, it has been reported that cervical length in the third trimester of pregnancy is helpful for predicting antenatal bleeding [12,14,15]. However, Hasegawa et al did not attempt to measure cervical length [13].…”

Section: Resultsmentioning

confidence: 99%

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The Risk Factors for Antenatal Bleeding in Pregnancy with Placenta Previa

Cho¹

2017

J Preg Child Health

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Objective: The majority of previa-related bleeding is due to an adhesive placenta. The risk factors are already well known. Although antenatal bleeding in women with placenta previa is another problem, the risk factors have not been identified. Our aim is to investigate the risk factors for antenatal bleeding in women with placenta previa. Methods:This was a retrospective study of postpartum women who received an ultrasound diagnosis of placenta previa. Included women were divided into two groups based on whether they had antenatal bleeding or not. Sonographic images were reviewed. Parameters assessed included loss of the retroplacental clear zone, irregularity of uterine-bladder interface, number of lacunar spaces, vasa previa and increased vascularity around placenta. We also assessed the type of placenta previa, placenta location, cervical length at third trimester and obstetric histories. Statistical analyses were performed using a t-test, X 2 test and logistic regression test. Results:Of 109 patients included, 55 (50.5%) experienced antenatal bleeding. There was no significant difference in maternal age between the two groups (P=0.903). Obstetric histories, cervical length at third trimester and sonographic findings were not significantly different. Conclusion:Prediction of antenatal bleeding in placenta previa using obstetrical history and sonographic finding is difficult.

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Section: Resultsmentioning

confidence: 69%

Section: Resultsmentioning

confidence: 99%

The Risk Factors for Antenatal Bleeding in Pregnancy with Placenta Previa

Cho¹

2017

J Preg Child Health

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“…28 Zaitoun et al reported similar findings regarding the value of cervical length as predictor of bleeding. 29 They found that patients with placenta previa and cervical length >30 mm had fewer emergency CD <36 weeks (10% versus 46%, p=0.002) and higher mean birth weights (2.8 versus 1.9 kg, p=0.003) as compared to those with cervical lengths ≤ 30 mm. Similar findings were reported by Fukushima et al where 77% of patients with placenta previa and cervical length >30 mm delivered >37 weeks as compared to only 50% of those with cervical length ≤ 30 mm who required emergency CD due to bleeding <37weeks' gestation (p=0.04); an additional finding was that a short cervix (≤ 30 mm) was associated with morbidly adherent placenta requiring cesarean hysterectomy in 35% of the cases as compared to only 6% in those with cervical length >30 mm (p=0.004).…”

Section: Discussionmentioning

confidence: 99%

“…29,31 Studies have shown that patients with placenta previa with "thick" placental edges over the internal OS (>1 cm thickness), as compared to those with thin placental edges over the internal OS (<1 cm) have a significantly higher frequency of APH episodes (3.8±1.6 versus 1.6±0.7), require more emergency CD <36 weeks (53% versus 26%; p=0.002), require more blood transfusions (2.4±2.6 versus 1.03±1.3 units; p=0.004), and have lower mean birth weight (1.93±0.47 versus 2.72±0.86 kg; p=0.006). 29,31 Present findings regarding a possible association between cervical length and trans cervical placental thickness measurement at 28-30 weeks gestation and the risk of emergent delivery in patients with PA have not been reported previously and may improve our ability to predict the clinical course and to refine obstetric management in these cases. If present data are confirmed on larger numbers, an earlier hospital admission or at least closer clinical monitoring in women with placenta previa and short cervix may become an option with delayed delivery with women with who deemed clinically stable in order to decrease the risks associated with prematurity.…”

Section: Discussionmentioning

confidence: 99%

Placenta accreta and emergency cesarean delivery correlates to cervical length and transcervical placental thickness measurement

Shady¹,

Sallam²,

Abbas³

2017

Int J Reprod Contracept Obstet Gynecol

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Background: The study aims to evaluate the effect of cervical length and the transcervical placental thickness measurement at 28-30 weeks gestation in predicting the risk of antepartum haemorrhage (APH) and emergency preterm caesarean delivery (CD) in women with placenta previa accreta.Methods: A prospective cohort study conducted at Aswan university hospital from June 2015 to April 2017 included one hundred and five cases diagnosed as placenta previa accreta by transvaginal ultrasound (TVS) between 28-30 weeks gestation were divided into three groups according to their cervical length which measured by TVS: group I (cervical length >30 mm), group II (cervical length 20-30 mm) and group III (cervical length <20 mm). Also, placental thickness measurement was done. Cervical length and placental thickness and correlated with the clinical outcome regarding to gestational age at delivery, APH, emergency CD due to massive haemorrhage, the need for blood transfusion and caesarean hysterectomy.Results: APH and emergency CD due to massive bleeding were significantly higher in cases with short cervical length and thick placenta. APH occurred in 6 cases (15%) in group I, 14 cases (40%) in group II and 24 cases (80%) in group III, (p=0.0001). Emergency CD in group I was performed in 5 cases (12.5 %), 12 cases (34.3 %) in group II and 24 cases (80%) in group III, (p =0.0001). The incidence of APH was higher in thick placenta [6 cases (42.9 %) compared to none with thin placenta in group I (p=0.001), 13 cases (68.4%) compared to one case (6.2%) in group II (p=0.0001) and 21 cases (100%) compared to 3 cases (33.3%) in group III (p=0.0001)].Conclusions: Short cervical length and increased placental thickness may predict the risk of APH and emergency preterm CD in patients with placenta accreta.

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“…There are a number of papers which already described the predicting factors of placenta previa including cervical length (3). Although several ultrasonographic findings of short cervical length are associated with bad consequences such as emergency CS, cesarean hysterectomy, intraoperative blood loss and placental adherence/accreta in patients with placenta previa (3)(4)(5)(6)(7), there is no research work describing the predictive value of the cervical length for pernicious placenta previa. Therefore, this study focused on the ultrasonographic findings of the cervix, and assessed their clinical usefulness as predictors for massive hemorrhage during a cesarean section in pernicious placenta previa.…”

Section: Introductionmentioning

confidence: 99%

The cervical length correlates with the amount of bleeding during cesarean section of the pernicious placenta previa

Feng¹

2017

JPM

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Introduction: to investigate the association between the amount of bleeding during a cesarean section and the effacement of the uterine cervix in patients with pernicious placenta previa. Methods: this study reviewed 50 singleton pregnancies with pernicious placenta previa. In cases of pernicious placenta previa, the cervical length were retrospectively measured and compared with the amount of bleeding during the cesarean section. Results: there was a significantly negative correlation between the amount of bleeding and cervical length (r = -0.390, P =0.005). The threshold cervical length associated with massive bleeding (>2500 mL) was 34.5mm, based on an ROC curve. Then, all cases were stratified by cervical length, ≤34.5mm was defined as Group S, and 34.5 mm as Group L. The amount of bleeding in Group S was significantly larger than in Group L, and the length of hospital stay was longer in Group S. It was also found that hysterectomy after CS was significantly higher in Group S than in Group L. However, there were no significant differences in any of the other maternal demographics between the two groups. Conclusion: this study demonstrated that a short cervical length, in cases with pernicious placenta previa, was associated with massive bleeding during the operation. In addition, short cervical length seems to be one of the warning signs for massive bleeding and cesarean hysterectomy during the operation for pernicious placenta previa.

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Does cervical length and the lower placental edge thickness measurement correlates with clinical outcome in cases of complete placenta previa?

Abstract: Short cervical length at cut-off value ≤30 mm and increased lower placental edge thickness measurements may predict with high accuracy the risk of APH and emergency preterm cesarean delivery in patients with complete placenta previa.

Cited by 41 publications

References 17 publications

The Risk Factors for Antenatal Bleeding in Pregnancy with Placenta Previa

The Risk Factors for Antenatal Bleeding in Pregnancy with Placenta Previa

Placenta accreta and emergency cesarean delivery correlates to cervical length and transcervical placental thickness measurement

The cervical length correlates with the amount of bleeding during cesarean section of the pernicious placenta previa

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