The Incidence of Postpartum Hemorrhage in Pregnant Women with Placenta Previa: A Systematic Review and Meta-Analysis

Fan, Dazhi; Xia, Qing; Liu, Li; Wu, Shuzhen; Tian, Guo; Wang, Wen; Wu, Song; Guo, Xiaoling; Liu, Zheng­ping

doi:10.1371/journal.pone.0170194

Cited by 83 publications

(64 citation statements)

References 41 publications

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“…A low‐lying placenta may be associated with maternal and fetal‐neonatal complications as well. However, according to a recently published meta‐analysis focusing on the risk of postpartum haemorrhage (PPH), the incidence of PPH was significantly lower in women with low‐lying placenta than in women with placenta praevia . Women with a low‐lying placenta usually remain asymptomatic during the first trimester of pregnancy and are generally diagnosed during routine sonography in the second trimester .…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

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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“…Maternal death continues to occur in patients with PAS, even with adequate diagnosis and surgical planning . In addition, the incidence of PPH in placenta praevia totalis is 22%, making it far more common in these patients than in uncomplicated pregnancies . The question of how to keep patients safe and preserve the uterus during a crisis involving major PPH remains a challenge in modern obstetric practice.…”

Section: Introductionmentioning

confidence: 99%

‘Nausicaa’ compression suture: a simple and effective alternative to hysterectomy in placenta accreta spectrum and other causes of severe postpartum haemorrhage

Shih

Liu

Kang

et al. 2018

BJOG

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Postpartum haemorrhage (PPH), especially resulting from placenta accreta spectrum (PAS), has become a worldwide concern in maternity care. We describe a novel method of uterine compression sutures (the 'Nausicaa' technique) as an alternative to hysterectomy for patients who have suffered from major PPH. We applied this technique in 68 patients with major PPH during caesarean section (including 43 patients with PAS, 20 patients with placenta praevia totalis, and five patients with uterine atony), and none of these patients required further hysterectomy. We conclude that our Nausicaa suture is a simple and feasible alternative to hysterectomy in patients suffering from major PPH.

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“…In our study 33.3% (36) of cases had preterm delivery (<37 weeks) which was similar to the study done by Ananth et al (39.7%). 12 In our study 31.4% of the patients had post-partum haemorrhage, 9,10 and 63.8% were in need of blood transfusion (blood and blood products). 7.4% had DIVC and 1.8% (2) cases died due to the complications.…”

Section: Discussionmentioning

confidence: 48%

“…There were 34 cases (31.4%) of postpartum haemorrhage in this study which is similar to the study done by Fan D, Xia Q, Liu L, et al (22.2%). 9,10 In our study 94 cases (87%) were in need of additional manoeuvres (prophylactic and therapeutic) to control bleeding which includes B-lynch stitch (4.6%), uterine artery ligation (45.3%) and uterine artery ligation with Foley tamponade (22.2%).…”

Section: Discussionmentioning

confidence: 71%

Study of Placenta Praevia and Its Foetomaternal Outcome in a Tertiary Care Center- Mgmgh, Trichy

Sellathamby¹,

Baskaran²

2019

jebmh

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BACKGROUND The highest prevalence of placenta praevia internationally is in Asian women. Placenta praevia is found to complicate 0.4% to 0.5% of all pregnancies and is one of the major causes of third trimester haemorrhage which is increasing in incidence due to rise in caesarean delivery rates. This dreaded and devastating complication is the important cause of maternal and perinatal morbidity and mortality in India. METHODS This is a retrospective study conducted in the department of OBG, Mahatma Gandhi Memorial Government Hospital, attached to K. A. P. Viswanatham Medical College, Trichy for a period of one year from January 2018 to December 2018. All cases of placenta praevia during pregnancy admitted in labour ward during this period were included in the study. All case records were obtained from the medical record section, and carefully analysed to find out the incidence, various types of placenta praevia, its clinical presentation, and its outcome in relation to mode of delivery, birth weight, and maternal/perinatal morbidity. RESULTS During the study period, a total of 8734 patients delivered; out of these, 108 patients with placenta praevia were encountered, which makes the prevalence of placenta praevia 1.2% and was more commonly present among multiparous women (73.1%). Out of 108 cases, 70 cases (64.8%) were delivered by caesarean section and 8 cases (7.4%) underwent peripartum hysterectomy. Incidence of placenta praevia in scarred uterus was found to be 76 (70.3%) which was much higher than in unscarred uterus.

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The Incidence of Postpartum Hemorrhage in Pregnant Women with Placenta Previa: A Systematic Review and Meta-Analysis

Cited by 83 publications

References 41 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

‘Nausicaa’ compression suture: a simple and effective alternative to hysterectomy in placenta accreta spectrum and other causes of severe postpartum haemorrhage

Study of Placenta Praevia and Its Foetomaternal Outcome in a Tertiary Care Center- Mgmgh, Trichy

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