Skip to main content

Advertisement

Log in

Planned versus urgent deliveries in placenta previa: maternal, surgical and neonatal results

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Placenta previa is abnormal localization of the placenta, associated with high rates of maternal–fetal morbidity and mortality. This abnormal implantation may also be in the form of invasion to surroundings defined as placenta accreta spectrum (PAS). The increasing rates of cesarean section raise the frequency of placenta previa and PAS in recent years. Although there are some recommendations, the optimal timing of caesarean delivery concerning fetal and maternal benefits is still unclear. The aim of this study is to compare maternal, surgical and perinatal outcomes of placenta previa cases who underwent emergency or planned surgery.

Methods

The women who underwent cesarean section for placenta previa between October 2013 and February 2019 at a tertiary care center were retrospectively analyzed. They were divided into two main groups as planned and urgent, and into two subgroups as complicated (PAS) and uncomplicated (non-PAS).

Results

Of the 313 women who met the inclusion criteria, 176 were planned and 137 were urgent cesarean sections. In the urgent group, gestational age, duration of surgery, maternal preoperative and pre-discharge hemoglobin levels, requirement of blood and blood product, additional surgical interventions, length of maternal postoperative intensive care unit and hospital stay, neonatal birthweight, Apgar scores, length of the follow-up in neonatal intensive care unit, invasive and non-invasive mechanical ventilation were significantly different.

Conclusions

Maternal complication rates are increased in women who are operated on emergency conditions due to placenta previa. Perinatal outcomes are better in women who underwent planned surgery and in those with gestational age greater than 37 weeks.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Coskun B, Akkurt I, Dur R et al (2018) Prediction of maternal near-miss in placenta previa: a retrospective analysis from a tertiary center in Ankara, Turkey. J Matern Neonatal Med 31(3):370–375

    Article  Google Scholar 

  2. Allahdin S, Voigt S, Htwe TT (2011) Management of placenta praevia and accreta. J Obstet Gynaecol 31(1):1–6

    Article  CAS  Google Scholar 

  3. Clark SL, Koonings PP, Phelan JP (1985) Placenta previa/accreta and prior cesarean section. Obstet Gynecol 66(1):89–92

    PubMed  CAS  Google Scholar 

  4. Usta IM, Hobeika EM, Musa AAA, Gabriel GE, Nassar AH (2005) Placenta previa-accreta: risk factors and complications. Am J Obstet Gynecol 193(3 Pt 2):1045–1049

    Article  Google Scholar 

  5. Bencaiova G, Burkhardt T, Beinder E (2007) Abnormal placental invasion experience at 1 center. J Reprod Med 52(8):709–714

    PubMed  Google Scholar 

  6. Jauniaux E, Alfirevic Z, Bhide AG et al (2019) Placenta praevia and placenta accreta: diagnosis and management: green-top guideline no 27a. BJOG 126(1):e1–e48

    Article  Google Scholar 

  7. Erfani H, Kassir E, Fox KA et al (2019) 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 32(6):906–909

    Article  Google Scholar 

  8. Sekiguchi A, Nakai A, Okuda N, Inde Y, Takeshita T (2015) Consecutive cervical length measurements as a predictor of preterm cesarean section in complete placenta previa. J Clin Ultrasound 43(1):17–22

    PubMed  Google Scholar 

  9. Ruiter L, Eschbach SJ, Burgers M et al (2016) Predictors for emergency cesarean delivery in women with placenta previa. Am J Perinatol 33(14):1407–1414

    Article  Google Scholar 

  10. Pivano A, Alessandrini M, Desbriere R et al (2015) A score to predict the risk of emergency caesarean delivery in women with antepartum bleeding and placenta praevia. Eur J Obstet Gynecol Reprod Biol 195:173–176

    Article  Google Scholar 

  11. https://dosyamerkez.saglik.gov.tr/Eklenti/28084,acilobstetrikbakimyonetimrehberipdf.pdf?0

  12. Jauniaux E, Ayres-de-Campos D, Duncombe G et al (2018) FIGO consensus guidelines on placenta accreta spectrum disorders: introduction. Int J Gynecol Obstet 140(3):261–264

    Article  Google Scholar 

  13. Pagani G, Cali G, Acharya G, Trisch IT, Palacios-Jaraquemada J, Familiari A et al (2018) Diagnostic accuracy of ultrasound in detecting the severity of abnormally invasive placentation: a systematic review and meta-analysis. Acta Obstet Gynecol Scand 97(1):25–37

    Article  Google Scholar 

  14. Cahill AG, Beigi R, Heine RP, Silver RM, Wax JR (2018) Obstetric care consensus no 7: placenta accreta spectrum. Obstet Gynecol 32(6):e259–e275

    Google Scholar 

  15. Wang Y, Zeng L, Niu Z, Chong Y, Zhang A, Mol B, Zhao Y (2019) An observation study of the emergency intervention in placenta accreta spectrum. Arch Gynecol Obstet 299(6):1579–1586

    Article  Google Scholar 

  16. Nørgaard LN, Pinborg A, Lidegaard Ø, Bergholt T (2012) A Danish national cohort study on neonatal outcome in singleton pregnancies with placenta previa. Acta Obstet Gynecol Scand 91(5):546–551

    Article  Google Scholar 

  17. Tikkanen M, Paavonen J, Loukovaara M, Stefanovic V (2011) Antenatal diagnosis of placenta accreta leads to reduced blood loss. Acta Obstet Gynecol Scand 90(10):1140–1146

    Article  Google Scholar 

  18. Fitzpatrick KE, Sellers S, Spark P, Kurinczuk JJ, Brocklehurst P, Knight M (2014) The management and outcomes of placenta accreta, increta, and percreta in the UK: a population-based descriptive study. BJOG 121(1):61–62

    Article  Google Scholar 

  19. Gyamfi-Bannerman C, Thom EA, Blackwell SC et al (2016) Antenatal betamethasone for women at risk for late preterm delivery. N Engl J Med 374(14):1311–1320

    Article  CAS  Google Scholar 

  20. Roberts D, Brown J, Medley N, Dalziel SR (2017) Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane database Syst Rev 3:CD004454

    PubMed  Google Scholar 

Download references

Acknowledgements

None.

Funding

This study was not funded.

Author information

Authors and Affiliations

Authors

Contributions

HD: Project development, data collection, analysis, manuscript writing and review. OBD: data collection and interpretation and analysis, manuscript writing and review. FGY: project development, manuscript review and amendments.

Corresponding author

Correspondence to Hüseyin Durukan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Before the operation, informed consent of all patients to cesarean section, possible application of Bakri balloon tamponade, additional surgical procedures, hysterectomy and retrospective use of the data in scientific research was obtained. Ethics approval for this retrospective study was granted by the Clinical Research Ethics Committee of Mersin University on 20/02/2019 with the Registration Number: 2019/90.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Durukan, H., Durukan, Ö.B. & Yazıcı, F.G. Planned versus urgent deliveries in placenta previa: maternal, surgical and neonatal results. Arch Gynecol Obstet 300, 1541–1549 (2019). https://doi.org/10.1007/s00404-019-05349-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-019-05349-9

Keywords

Navigation