Maternal and neonatal outcomes of placenta previa with and without coverage of a uterine scar: A retrospective cohort study in a tertiary hospital

Abstract

Background To compare the maternal and neonatal outcomes of placenta previa (PP) with and without coverage of a uterine scar in Foshan, China. Methods A retrospective cohort study comparing all singleton pregnancies with PP was conducted at a tertiary, university-affiliated medical center from 1 January 2012 to 31 April 2017 in Foshan, China. Demographic, clinical and laboratory data were extracted from electronic medical records. Maternal and neonatal outcomes of PP with and without coverage of a uterine scar were compared by statistical method. Results There were 58,062 deliveries during the study period, of which 738 (1.27%) were complicated PP in singleton pregnancies and were further classified into two groups: the PP with coverage of a uterine scar group (PPCS, n = 166) and the PP without coverage of a uterine scar group (Non-PPCS, n = 572). Overall, premature birth (< 37 weeks,68.1% vs 54.8%; P = 0.010), cesarean section(100% vs 97.6%; P = 0.042), Intraoperative blood loss > 1000 ml (78.3% vs 16.0%; P < 0.001) or > 3000 ml (29.5% vs 3.0%; P < 0.001), postpartum hemorrhage(48.8% vs 15.7%; P < 0.001), transfusion (35.2% vs 16.1%; P < 0.001), hemorrhage shock(8.4% vs 1.9%; P < 0.001), hysterectomy (3.0% vs 0.5%; P = 0.006) and fetal distress (36.1% vs 12.0%; P < 0.001) had a significant difference between PPCS group and Non-PPCS group. After grouping by whether complicated with AIP, we found that PPCS was significant associated with more intraoperative blood loss༞1000 ml, intraoperative blood loss༞3000 ml, bleeding within 2–24 hours after delivery, fetal distress and higher hospitalization expenses than the Non-PPCS group. After grouping by whether complicated with AIP and different placenta positions(Anterior, Posterior and Ante-posterior or laterally positioned), we found that PPCS was significant associated with more intraoperative blood loss༞1000 ml and higher hospitalization expenses than the Non-PPCS in AIP women and more intraoperative blood loss༞1000 ml, postpartum hemorrhage and higher hospitalization expenses in Non-AIP women. Conclusion The PPCS group had poorer maternal and neonatal outcomes than the Non-PPCS group after grouping by whether pregnancies complicated with AIP or with different placental positions.

Maternal And Fetal Outcome in Placenta Previa: A Multicenter Prospective Observational Study

“…18 In our study, a low APGAR score was observed in 25.85% of neonates. Low APGAR frequency was 15.2% in a similar study conducted by Rao J et al 19 Low birth weight was found to be 35.75% in our study. It was observed in our study that most of the babies (59.61%) with low birth weight had a low 5minute APGAR score.…”