Gülşen Doğan DURDAĞ
(Başkent Üniversitesi Tıp Fakültesi, Adana Uygulama ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum AD Adana, Türkiye)
Hakan KALAYCI
(Başkent Üniversitesi Tıp Fakültesi, Adana Uygulama ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum AD Adana, Türkiye)
Şafak Yılmaz BARAN
(Başkent Üniversitesi Tıp Fakültesi, Adana Uygulama ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum AD Adana, Türkiye)
Seda Yüksel ŞİMŞEK
(Başkent Üniversitesi Tıp Fakültesi, Adana Uygulama ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum AD Adana, Türkiye)
Songül ALEMDAROĞLU
(Başkent Üniversitesi Tıp Fakültesi, Adana Uygulama ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum AD Adana, Türkiye)
Serdinç ÖZDOĞAN
(Başkent Üniversitesi Tıp Fakültesi, Adana Uygulama ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum AD Adana, Türkiye)
Esra Bulgan KILIÇDAĞ
(Başkent Üniversitesi Tıp Fakültesi, Adana Uygulama ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum AD Adana, Türkiye)
Yıl: 2021Cilt: 27Sayı: 1ISSN: 1300-4751 / 2602-4918Sayfa Aralığı: 23 - 27İngilizce

108 0
Placental Location Affects Cesarean Complications in Patients with Placenta Previa
OBJECTIVE: Placenta previa may cause massive hemorrhage at antenatal, intrapartum or postpartumperiods and is one of the leading causes of maternal morbidity and mortality. Anterior or posterior location of placenta previa can change cesarean technique and management of the operation. Aim of thisstudy is to assess factors increasing intraoperative complications in patients with placenta previa and investigate the significance of anterior placenta location apart from other factors.STUDY DESIGN: This is a retrospective cohort study which was conducted in one center including 83patients followed with placenta previa in three years’ duration. Placental location, presence, and depthof myometrial invasion, previous uterine surgery and the type of uterine incision were evaluated.Intraoperative hemorrhage, need for blood transfusion and hysterectomy, complete blood count parameters of mother and newborn were compared between the anterior and posterior placenta previa.RESULTS: Previous uterine surgery, abnormally invasive placenta and need for blood transfusion weresignificantly higher in patients with anterior placenta previa. The increasing number of previous cesareanoperations enhanced placental invasion to cesarean scar area in anterior placentation, leading to higherrates of blood transfusion, classical incision, and hysterectomy. Also, when the patients with previouscesarean or classical incision were excluded, anterior placentation differed significantly when comparedwith posterior placentation with respect to hemoglobin differences between preoperative and postoperative values.CONCLUSION: Anterior location of placenta previa increases hemorrhagic complications. Placental location, presence, and depth of invasion should be assessed and timing of delivery should be plannedwith appropriate preparation of blood products before delivery.
DergiAraştırma MakalesiErişime Açık
  • 1. Gibbins KJ. Einerson BD. Varner MW. Silver RM. Placenta previa and maternal hemorrhagic morbidity. J Matern Fetal Neonatal Med. 2018;31(4):494-9. doi: 10.1080/14767058.2017.1289163.
  • 2. Baba Y. Matsubara S.Ohkuchi A. Usui R. Kuwata T. Suzuki H. et al. Anterior placentation as a risk factor for massive hemorrhage during cesarean section in patients with placenta previa. J Obstet Gynaecol Res. 2014;40(5): 1243-8. doi: 10.1111/jog.12340.
  • 3. Baba Y. Ohkuchi A. Usui R. Suzuki H. Kuwata T. Matsubara S. Calculating probability of requiring allogeneic blood transfusion using three preoperative risk factors on cesarean section for placenta previa. Arch Gynecol Obstet. 2015;291(2):281-5. doi: 10.1007/s00404-014- 3451-x.
  • 4. Baba Y. Takahashi H. Ohkuchi A. Usui R. Matsubara S. Which type of placenta previa requires blood transfusion more frequently? A new concept of indiscernible edge total previa. J Obstet Gynaecol Res. 2016;42(11):1502-8. doi: 10.1111/jog.13097.
  • 5. Fukushima K. Fujiwara A. Anami A. Fujita Y. Yumoto Y. Sakai A. et al. Cervical length predicts placental adherence and massive hemorrhage in placenta previa. J Obstet Gynaecol Res. 2012;38(1):192-7. doi: 10.1111/j.1447- 0756.2011.01669.x.
  • 6. Young BC. Nadel A. Kaimal A. Does previa location matter? Surgical morbidity associated with location of a placenta previa. J Perinatol. 2014;34(4):264-7. doi: 10.1038/jp.2013.185.
  • 7. Grobman WA. Gersnoviez R. Landon MB. Spong CY. Leveno KJ. Rouse DJ. et al. Pregnancy outcomes for women with placenta previa in relation to the number of prior cesarean deliveries. Obstet Gynecol. 2007;110(6): 1249-55. doi: 10.1097/01.AOG.0000292082.80566.cd.
  • 8. Allen L. Jauniaux E. Hobson S. Papillon-Smith J. Belfort MA. FIGO Placenta Accreta Diagnosis and Management Expert Consensus Panel. FIGO consensus guidelines on placenta accreta spectrum disorders: Nonconservative surgical management. Int J Gynecol Obstet. 2018;140 (3):281-90. doi: 10.1002/ijgo.12409.
  • 9. Giambattista E. Ossola MW. Duiella SF. Crovetto F. Acaia B. Somigliana E. et al. Predicting factors for emergency peripartum hysterectomy in women with placenta previa. Arch Gynecol Obstet. 2012;285(4):901-6. doi: 10.1007/s00404-011-2074-8.
  • 10. Eller AG. Porter TF. Soisson P. Silve RM. Optimal management strategies for placenta accreta. BJOG. 2009; 116(5):648-54. doi: 10.1111/j.1471-0528.2008.02037.x.
  • 11. Smulian JC. Pascual AL. Hesham H. Qureshey E. Bijoy Thomas M. Depuy AM. et al. Invasive placental disease: The impact of a multi-disciplinary team approach to management. J Matern Fetal Neonatal Med. 2017;30(12): 1423-7. doi: 10.1080/14767058.2016.1216099.
  • 12. Clausen C. Lönn L. Langhoff-Roos J. Management of placenta percreta: a review of published cases. Acta Obstet Gynecol Scand. 2014;93(2):138-43. doi: 10.1111/aogs. 12295.
  • 13. Matsubara S. Baba Y. Takahashi H. Placenta previa and hemorrhage: the placental location may be an important determinant of the bleeding amount. J Matern Fetal Neonatal Med. 2018;31(10):1390-1. doi:10.1080/ 14767058.2017.1315664.
  • 14. Soyama H, Miyamoto M, Ishibashi H, Takano M, Sasa H, Furuya K. Relation between birth weight and intraoperative hemorrhage during cesarean section in pregnancy with placenta previa. PLoS One. 2016;11(11):e0167332. doi: 10.1371/journal.pone.0167332. eCollection 2016.

TÜBİTAK ULAKBİM Ulusal Akademik Ağ ve Bilgi Merkezi Cahit Arf Bilgi Merkezi © 2019 Tüm Hakları Saklıdır.