Planned vaginal delivery versus planned cesarean delivery in cases of low-lying placenta

Taga, Atsuko; Sato, Yukiyasu; Sakae, Chieko; Satake, Yumiko; Emoto, Ikuko; Maruyama, Shunsuke; Mise, Hiroko; Kim, Tomoko

doi:10.1080/14767058.2016.1181168

Cited by 16 publications

(24 citation statements)

References 10 publications

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“…One study showed a significant difference in blood transfusion between IOD but, unexpectedly, more blood transfusion was needed in the group with the larger IOD . The other studies did not show a difference in blood transfusion between the different IODs …”

Section: Resultsmentioning

confidence: 97%

“…The second study found that a caesarean section group had significantly more intrapartum haemorrhage compared with the vaginal delivery group ( P = 0.047), which resulted in more blood transfusion in the scheduled caesarean group …”

Section: Resultsmentioning

confidence: 97%

“…Most studies divided their cohort into subgroups to compare different cut‐off values. Four studies used 9 or 10 mm as a cut‐off distance to compare groups . In our analysis, we merged these studies creating four studies with a cut‐off distance of 10 mm.…”

Section: Resultsmentioning

confidence: 99%

“…A vaginal delivery has been shown to be more often successful in anterior than in posterior placenta praevia ( P = 0.037) . Considering another factor, Taga et al . suggested that all women with a low‐lying placenta should be offered a trial of labour except those accompanied by a marginal sinus, defined as a hypo‐echogenic area with slow blood flow, at the end of the third trimester.…”

Section: Discussionmentioning

confidence: 99%

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Vaginal delivery in women with a low‐lying placenta: a systematic review and meta‐analysis

Jansen

Mooij

Blomaard

et al. 2019

BJOG

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Background Low‐lying placentas are positioned close to the internal os of the cervix. The preferred way of delivery within this group is unclear. Objectives To review the literature on the success of a vaginal delivery with a low‐lying placenta. Search strategy We searched OVID EMBASE and MEDLINE for studies on vaginal delivery with a low‐lying placenta. Data collection and analyses Data was extracted on successful vaginal delivery and emergency caesarean section due to haemorrhage. We distinguished between different distances between the cervical os and the placenta (internal os distance, IOD); 0–10, 11–20, and >20 mm. A meta‐analysis of proportions was made for successful vaginal delivery and emergency caesarean section at every cut‐off value. Maternal morbidity (i.e. antepartum blood loss, postpartum haemorrhage and blood transfusion) at different cut‐off values was evaluated. Main results Of the 999 articles retrieved, 10 articles met our inclusion criteria. A vaginal delivery was successful at an IOD of 0–10 mm in 43%, at an IOD of 11–20 mm in 85%, and at an IOD of >20 mm in 82%. A shorter IOD had a higher chance of antepartum haemorrhage, whereas a larger IOD needed postpartum blood transfusion more often. Postpartum haemorrhage did not depend on IOD. Conclusion A low‐lying placenta is not a contraindication for a trial of labour, and the morbidity in these women is not increased. However, women with a low‐lying placenta have a higher chance of an emergency caesarean section compared with women with a placenta outside the lower uterine segment. Therefore, shared decision‐making is mandatory in case of a trial of labour. Tweetable abstract This systematic review demonstrates the possibility of a vaginal delivery in women with a low‐lying placenta within 20 mm of the cervix.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Vaginal delivery in women with a low‐lying placenta: a systematic review and meta‐analysis

Jansen

Mooij

Blomaard

et al. 2019

BJOG

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“…Ohira et al reported that the presence of the marginal sinus was associated with subsequent cesarean delivery because of antepartum vaginal bleeding in cases of low‐lying placenta. Taga et al also reported that women with low‐lying placenta required emergent cesarean delivery because of bleeding in the presence of the marginal sinus. We thought that rupture of the marginal sinus of the placenta exists.…”

Section: Discussionmentioning

confidence: 99%

Descended marginal sinus of the placenta

Ryo

Namai

Nakagawa

et al. 2019

Clinical Case Reports

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Pregnancy and Delivery Outcomes in Women With Persistent Versus Resolved Low‐Lying Placenta in the Late Third Trimester

Ornaghi

Tessitore

Vergani

2021

J of Ultrasound Medicine

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Objectives The safest mode of delivery in low‐lying placenta is debatable. Little is known about outcomes in low‐lying placenta resolved during the late third trimester. We compare outcomes of women with persistent versus resolved low‐lying placenta. Methods A retrospective analysis on a prospective cohort of women with low‐lying placenta confirmed at 28–30 weeks sonography (01/2009 to 03/2018). Women were followed up serially every 2 to 3 weeks until delivery to assess the placental edge‐to‐internal os distance (IOD), and included if scan was performed within 28 days before delivery. Results There were 86 women: in 21 the low‐lying placenta resolved, whereas in 65 persisted (n = 15 IOD 1–10 mm, n = 50 IOD 11–20 mm). Antepartum bleeding associated with higher rates of urgent cesarean delivery in 1–10 mm (P = .041) but not in 11–20 mm (P = 1.000) and >20 mm (P = .333). Among women with IOD >10 mm allowed to labor, vaginal delivery occurred in 76.7% (11–20 mm) and 94.1% (>20 mm) (P = .155), with no difference according to parity (70% and 80% in multiparas, P = .696; 60% and 72.7% in nulliparas, P = .698). Severe PPH (P = .922) and hemoglobin drop (P = .109) were similar among groups. Women with IOD 11–20 mm and >20 mm and vaginal delivery bled less than women with similarly located placenta and cesarean delivery (P = .009 and P = .048). Conclusions Women with IOD >10 mm have high chances of deliver vaginally with no further increase of their hemorrhagic risk. Success of vaginal delivery is independent of parity and antepartum bleeding. Labor should be managed in an adequate hospital setting.

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Planned vaginal delivery versus planned cesarean delivery in cases of low-lying placenta

Abstract: Trial of labor can be offered to all the women with low-lying placenta except for those accompanied by marginal sinus.

Cited by 16 publications

References 10 publications

Vaginal delivery in women with a low‐lying placenta: a systematic review and meta‐analysis

Vaginal delivery in women with a low‐lying placenta: a systematic review and meta‐analysis

Descended marginal sinus of the placenta

Pregnancy and Delivery Outcomes in Women With Persistent Versus Resolved Low‐Lying Placenta in the Late Third Trimester

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