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Pregnancy Outcomes of Placenta Previa with or without Antepartum Hemorrhage

Pornthip Luangruangrong MD*, Dennopporn Sudjai MD*, Busaba Wiriyasirivaj MD*, Chadakarn Paloprakarn MD*

Affiliation : * Department of Obstetrics and Gynecology, Vajira Hospital, Bangkok, Thailand


Objective : To compare pregnancy outcomes between antepartum hemorrhage (APH) and no APH in women with a diagnosis of placenta previa (PP). Material and Method: A retrospective cohort study was conducted in 60 gravidas diagnosed with PP. The study group (n = 30) consisted of women with APH while the control group (n = 30) comprised those without. The pregnancy outcomes were compared between the two groups. They included preterm birth, emergency cesarean section (CS), peripartum hysterectomy, requirement for blood transfusion, low birth weight (LBW), and birth asphyxia. Uni- and multivariable analyses were used for statistical analysis.
Results : Data of all 60 women were obtained. In univariable analysis, the study group had significantly higher risks of early, late, and overall preterm birth, emergency CS, blood transfusion, and LBW than the control group; odds ratio (95% confidence intervals) = 6.1 (1.5-25.0), 3.9 (1.1-21.2), 4.3 (1.6-11.2), 5.2 (2.3-11.7), 2.6 (1.4-4.6) and 3.7 (1.1-11.8) respectively. When multivariable analysis adjusted for potential confounders, these risks remained in the study group. The highest risk was an emergency CS with an adjusted odds ratio of 30.5 (4.1-227.3).
Conclusion : Women with PP complicated by APH had significantly higher risks of adverse pregnancy outcomes than women without APH.

Keywords : Antepartum hemorrhage, Placenta previa, Pregnancy outcomes


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