open access

Ahead of Print
Research paper
Published online: 2021-11-25
Get Citation

The comparison of maternal and neonatal outcomes between planned and emergency cesarean deliveries in placenta previa patients without placenta accreata spectrum

Zeynep Gedik Özköse1, Süleyman Cemil Oğlak2, Fatma Ölmez3
DOI: 10.5603/GP.a2021.0160
Affiliations
  1. Department of Perinatology, Health Sciences University, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
  2. Department of Obstetrics and Gynecology, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
  3. Department of Obstetrics and Gynecology, Health Sciences University, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey

open access

Ahead of Print
ORIGINAL PAPERS Obstetrics
Published online: 2021-11-25

Abstract

Objectives: This study aims to investigate whether a significant difference exists in maternal and fetal outcomes between planned cesarean delivery (PCD) compared to emergency cesarean delivery (ECD) in placenta previa (PP) patients without placenta accreata spectrum (PAS) in a tertiary referral hospital.

Material and methods: This retrospective cohort study included 237 singleton pregnant women who were diagnosed with PP without PAS at the time of delivery. PP patients who were delivered at the scheduled time were included in the PCD group. Patients with PP delivered in an emergency setting before the scheduled date were assigned to the ECD group. We recorded demographic and clinical characteristics, maternal and neonatal outcomes.

Results: Of the 237 patients who met the inclusion criteria, 157 patients (66.8%) underwent PCD, and 80 patients required ECD (33.2%). Patients’ hospitalization and pre-discharge hemoglobin levels were significantly lower in the ECD group (11.25 ± 1.97 g/dL and 9.74 ± 2.09 g/dL, respectively) than in the PCD group (10.77 ± 2.67 g/dL and 9.27 ± 2.70, p = 0.002 and p = 0.004, respectively). While six patients (7.5%) were required intensive care unit (ICU) admission in the ECD group, no patient was required to follow up in ICU in the PCD group (p < 0.001). The hospital length of stay (LOS) was tended to be significantly longer in the ECD group (2.8 ± 0.7 days) than in the PCD group (2.4 ± 0.6 days, p < 0.001). Neonatal outcomes of birth weight, Apgar scores, NICU admission, and neonatal death were significantly better in the PCD group than in the ECD group.

Conclusions: The PCD group has better maternal outcomes, including preoperative and discharge hemoglobin levels, ICU admission and hospital LOS, and better neonatal outcomes than the ECD group. Clinicians should pay regard to that scheduling the delivery to advanced pregnancy weeks has a failure possibility, and patients could not reach the scheduled day due to the emergency states.

Abstract

Objectives: This study aims to investigate whether a significant difference exists in maternal and fetal outcomes between planned cesarean delivery (PCD) compared to emergency cesarean delivery (ECD) in placenta previa (PP) patients without placenta accreata spectrum (PAS) in a tertiary referral hospital.

Material and methods: This retrospective cohort study included 237 singleton pregnant women who were diagnosed with PP without PAS at the time of delivery. PP patients who were delivered at the scheduled time were included in the PCD group. Patients with PP delivered in an emergency setting before the scheduled date were assigned to the ECD group. We recorded demographic and clinical characteristics, maternal and neonatal outcomes.

Results: Of the 237 patients who met the inclusion criteria, 157 patients (66.8%) underwent PCD, and 80 patients required ECD (33.2%). Patients’ hospitalization and pre-discharge hemoglobin levels were significantly lower in the ECD group (11.25 ± 1.97 g/dL and 9.74 ± 2.09 g/dL, respectively) than in the PCD group (10.77 ± 2.67 g/dL and 9.27 ± 2.70, p = 0.002 and p = 0.004, respectively). While six patients (7.5%) were required intensive care unit (ICU) admission in the ECD group, no patient was required to follow up in ICU in the PCD group (p < 0.001). The hospital length of stay (LOS) was tended to be significantly longer in the ECD group (2.8 ± 0.7 days) than in the PCD group (2.4 ± 0.6 days, p < 0.001). Neonatal outcomes of birth weight, Apgar scores, NICU admission, and neonatal death were significantly better in the PCD group than in the ECD group.

Conclusions: The PCD group has better maternal outcomes, including preoperative and discharge hemoglobin levels, ICU admission and hospital LOS, and better neonatal outcomes than the ECD group. Clinicians should pay regard to that scheduling the delivery to advanced pregnancy weeks has a failure possibility, and patients could not reach the scheduled day due to the emergency states.

Get Citation

Keywords

Placenta previa; severe hemorrhage; emergency cesarean delivery; planned cesarean delivery

About this article
Title

The comparison of maternal and neonatal outcomes between planned and emergency cesarean deliveries in placenta previa patients without placenta accreata spectrum

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Research paper

Published online

2021-11-25

DOI

10.5603/GP.a2021.0160

Keywords

Placenta previa
severe hemorrhage
emergency cesarean delivery
planned cesarean delivery

Authors

Zeynep Gedik Özköse
Süleyman Cemil Oğlak
Fatma Ölmez

References (29)
  1. Fan D, Wu S, Wang W, et al. Prevalence of placenta previa among deliveries in Mainland China: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2016; 95(40): e5107.
  2. Cresswell JA, Ronsmans C, Calvert C, et al. Prevalence of placenta praevia by world region: a systematic review and meta-analysis. Trop Med Int Health. 2013; 18(6): 712–724.
  3. Feng Y, Li XY, Xiao J, et al. Risk factors and pregnancy outcomes: complete versus incomplete placenta previa in mid-pregnancy. Curr Med Sci. 2018; 38(4): 597–601.
  4. Downes KL, Hinkle SN, Sjaarda LA, et al. Previous prelabor or intrapartum cesarean delivery and risk of placenta previa. Am J Obstet Gynecol. 2015; 212(5): 669.e1–669.e6.
  5. Karami M, Jenabi E, Fereidooni B. The association of placenta previa and assisted reproductive techniques: a meta-analysis. J Matern Fetal Neonatal Med. 2018; 31(14): 1940–1947.
  6. Obut M, Oglak S. Retrospective evaluation of placenta previa cases: A secondary-center experince. Namık Kemal Tıp Dergisi. 2020.
  7. Lal AK, Hibbard JU. Placenta previa: an outcome-based cohort study in a contemporary obstetric population. Arch Gynecol Obstet. 2015; 292(2): 299–305.
  8. Fan D, Xia Q, Liu Li, et al. The incidence of postpartum hemorrhage in pregnant women with placenta previa: A systematic review and meta-analysis. PLoS One. 2017; 12(1): e0170194.
  9. Oğlak SC, Bademkıran MH, Obut M. Predictor variables in the success of slow-release dinoprostone used for cervical ripening in intrauterine growth restriction pregnancies. J Gynecol Obstet Hum Reprod. 2020; 49(6): 101739.
  10. King LJ, Dhanya Mackeen A, Nordberg C, et al. Maternal risk factors associated with persistent placenta previa. Placenta. 2020; 99: 189–192.
  11. Spong CY, Mercer BM, D'Alton M, et al. Timing of indicated late-preterm and early-term birth. Obstet Gynecol. 2011; 118(2 Pt 1): 323–333.
  12. Ruiter L, Eschbach SJ, Burgers M, et al. Predictors for emergency cesarean delivery in women with placenta previa. Am J Perinatol. 2016; 33(14): 1407–1414.
  13. Perlman NC, Carusi DA, Carusi DA. The placenta accreta spectrum: epidemiology and risk factors. Clin Obstet Gynecol. 2018; 61(4): 733–742.
  14. Mullen C, Battarbee AN, Ernst LM, et al. Occult placenta accreta: risk factors, adverse obstetrical outcomes, and recurrence in subsequent pregnancies. Am J Perinatol. 2019; 36(5): 472–475.
  15. Li X, Feng Y. Complete placenta previa in the second trimester: clinical and sonographic factors associated with its resolution. Ginekol Pol. 2019; 90(9): 539–543.
  16. Jauniaux E, Alfirevic Z, Bhide AG, et al. Royal College of Obstetricians and Gynaecologists. Placenta praevia and placenta accreta: diagnosis and management: green-top guideline no. 27a. BJOG. 2019; 126(1): e1–e48.
  17. Balayla J, Wo BiL, Bédard MJ. A late-preterm, early-term stratified analysis of neonatal outcomes by gestational age in placenta previa: defining the optimal timing for delivery. J Matern Fetal Neonatal Med. 2015; 28(15): 1756–1761.
  18. Durukan H, Durukan ÖB, Yazıcı FG. Planned versus urgent deliveries in placenta previa: maternal, surgical and neonatal results. Arch Gynecol Obstet. 2019; 300(6): 1541–1549.
  19. Erfani H, Kassir E, Fox KA, et al. 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. 2019; 32(6): 906–909.
  20. ACOG committee opinion No. 764 summary: medically indicated late-preterm and early-term deliveries. Obstet Gynecol. 2019; 133(2): 400–403.
  21. Luangruangrong P, Sudjai D, Wiriyasirivaj B, et al. Pregnancy outcomes of placenta previa with or without antepartum hemorrhage. J Med Assoc Thai. 2013; 96(11): 1401–1407.
  22. Chung P, Cheer K, Malacova E, et al. Obstetric outcomes in major vs minor placenta praevia: A retrospective cohort study. Aust N Z J Obstet Gynaecol. 2020; 60(6): 896–903.
  23. Grönvall M, Stefanovic V, Paavonen J, et al. Pelvic arterial embolization in severe obstetric hemorrhage. Acta Obstet Gynecol Scand. 2014; 93(7): 716–719.
  24. Tuzovic L. Complete versus incomplete placenta previa and obstetric outcome. Int J Gynaecol Obstet. 2006; 93(2): 110–117.
  25. Gibbins KJ, Einerson BD, Varner MW, et al. Placenta previa and maternal hemorrhagic morbidity. J Matern Fetal Neonatal Med. 2018; 31(4): 494–499.
  26. Oğlak S, Obut M. Does keeping the Bakri balloon in place for longer than 12 hours provide favourable clinical outcomes in the treatment of uterine atony? Ege Tıp Dergisi. 2020; 59(3): 209–214.
  27. Oğlak SC, Tunç Ş, Obut M, et al. Maternal near-miss patients and maternal mortality cases in a Turkish tertiary referral hospital. Ginekol Pol. 2021; 92(4): 300–305.
  28. Oglak SC, Obut M, Tahaoglu AE, et al. A prospective cohort study of shock index as a reliable marker to predict the patient's need for blood transfusion due to postpartum hemorrhage. Pak J Med Sci. 2021; 37(3): 863–868.
  29. Balayla J, Desilets J, Shrem G. Placenta previa and the risk of intrauterine growth restriction (IUGR): a systematic review and meta-analysis. J Perinat Med. 2019; 47(6): 577–584.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl