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Placental Lesions and Pregnancy Outcome in Anterior as Compared to Posterior Placenta Previa

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Abstract

The uterine location of placenta previa (PP), anterior vs. posterior has an impact on pregnancy outcome. We aimed to study maternal and neonatal outcome and placental histopathology lesions in anterior vs. posterior PP. The medical records and histopathology reports of all singleton cesarean deliveries (CD) performed due to PP, from 24 to 41 weeks, between 12.2008 and 10.2018, were reviewed. Placental lesions were classified into maternal and fetal vascular malperfusion lesions (MVM, FVM), maternal and fetal inflammatory responses (MIR, FIR). Gestational age (GA) at delivery was similar between the anterior PP (n = 67) and posterior PP (n = 105) groups. As compared to the posterior PP group, the anterior PP group had higher rate of previous CD (p < 0.001), placental accreta spectrum (p = 0.04), lower neonatal Hb at birth (p = 0.03), higher rate of neonatal blood transfusion (p = 0.007) and prolonged maternal hospitalization (p = 0.02). Placentas from the anterior PP group had lower weights (p = 0.035), with increased rate of MVM lesions (p = 0.017). The anterior PP location is associated with increased adverse maternal and neonatal outcome, lower placental weights and increased rate of malperfusion lesions. Abnormal placentation in the scarred uterine wall probably has an impact on placental function.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Obstetrics & Gynecology, the Edith Wolfson Medical Center, Holon, Israel affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Daniel Tairy, Eran Weiner, Hadas Miremberg, Liat Gindes, Roni Hochman, Jacob Bar & Michal Kovo

  2. Department of Pathology, the Edith Wolfson Medical Center, Holon, Israel affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Letizia Schreiber

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  1. Daniel Tairy
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  2. Eran Weiner
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The authors state that each of the authors have provided substantial contribution and are in agreement with all aspects of the final manuscript.

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Correspondence to Daniel Tairy.

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All procedures were in accordance with the ethical standards of the institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Decision number 9-2010-0223 dated 18/03/2019.

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All authors declare no competing interests.

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Tairy, D., Weiner, E., Schreiber, L. et al. Placental Lesions and Pregnancy Outcome in Anterior as Compared to Posterior Placenta Previa. Reprod. Sci. 28, 3241–3247 (2021). https://doi.org/10.1007/s43032-021-00558-7

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  • DOI: https://doi.org/10.1007/s43032-021-00558-7

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