Placental Location Affects Cesarean Complications in Patients with Placenta Previa

Objective: Placenta previa may cause massive hemorrhage at antenatal, intrapartum or postpartum periods 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 this...

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Main Authors: Gulsen Dogan Durdag, Hakan Kalayci, Safak Yilmaz Baran, Seda Yuksel Simsek, Songul Alemdaroglu, Serdinc Ozdogan, Esra Bulgan Kilicdag
Format: Article
Language:English
Published: Medical Network 2021-04-01
Series:Gynecology Obstetrics & Reproductive Medicine
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Online Access:https://gorm.com.tr/index.php/GORM/article/view/965
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author Gulsen Dogan Durdag
Hakan Kalayci
Safak Yilmaz Baran
Seda Yuksel Simsek
Songul Alemdaroglu
Serdinc Ozdogan
Esra Bulgan Kilicdag
author_facet Gulsen Dogan Durdag
Hakan Kalayci
Safak Yilmaz Baran
Seda Yuksel Simsek
Songul Alemdaroglu
Serdinc Ozdogan
Esra Bulgan Kilicdag
author_sort Gulsen Dogan Durdag
collection DOAJ
description Objective: Placenta previa may cause massive hemorrhage at antenatal, intrapartum or postpartum periods 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 this study 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 83 patients followed with placenta previa in three years’ duration. Placental location, presence, and depth of 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 were significantly higher in patients with anterior placenta previa. The increasing number of previous cesarean operations enhanced placental invasion to cesarean scar area in anterior placentation, leading to higher rates of blood transfusion, classical incision, and hysterectomy. Also, when the patients with previous cesarean or classical incision were excluded, anterior placentation differed significantly when compared with 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 planned with appropriate preparation of blood products before delivery.
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spelling doaj-art-a707f766e6384eb19074bd42edfc9d642025-02-11T21:11:50ZengMedical NetworkGynecology Obstetrics & Reproductive Medicine1300-47512602-49182021-04-0127110.21613/GORM.2019.965Placental Location Affects Cesarean Complications in Patients with Placenta PreviaGulsen Dogan Durdag0Hakan Kalayci1Safak Yilmaz Baran2Seda Yuksel Simsek3Songul Alemdaroglu4Serdinc Ozdogan5Esra Bulgan Kilicdag6Başkent University, Adana Application and Research CenterBaşkent University, Adana Application and Research CenterBaşkent University, Adana Application and Research CenterBaşkent University, Adana Application and Research CenterBaşkent University, Adana Application and Research CenterBaşkent University, Adana Application and Research CenterBaşkent University, Adana Application and Research Center Objective: Placenta previa may cause massive hemorrhage at antenatal, intrapartum or postpartum periods 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 this study 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 83 patients followed with placenta previa in three years’ duration. Placental location, presence, and depth of 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 were significantly higher in patients with anterior placenta previa. The increasing number of previous cesarean operations enhanced placental invasion to cesarean scar area in anterior placentation, leading to higher rates of blood transfusion, classical incision, and hysterectomy. Also, when the patients with previous cesarean or classical incision were excluded, anterior placentation differed significantly when compared with 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 planned with appropriate preparation of blood products before delivery. https://gorm.com.tr/index.php/GORM/article/view/965Anterior placentationCesarean sectionHemorrhagePlacenta accretaPlacenta previa
spellingShingle Gulsen Dogan Durdag
Hakan Kalayci
Safak Yilmaz Baran
Seda Yuksel Simsek
Songul Alemdaroglu
Serdinc Ozdogan
Esra Bulgan Kilicdag
Placental Location Affects Cesarean Complications in Patients with Placenta Previa
Gynecology Obstetrics & Reproductive Medicine
Anterior placentation
Cesarean section
Hemorrhage
Placenta accreta
Placenta previa
title Placental Location Affects Cesarean Complications in Patients with Placenta Previa
title_full Placental Location Affects Cesarean Complications in Patients with Placenta Previa
title_fullStr Placental Location Affects Cesarean Complications in Patients with Placenta Previa
title_full_unstemmed Placental Location Affects Cesarean Complications in Patients with Placenta Previa
title_short Placental Location Affects Cesarean Complications in Patients with Placenta Previa
title_sort placental location affects cesarean complications in patients with placenta previa
topic Anterior placentation
Cesarean section
Hemorrhage
Placenta accreta
Placenta previa
url https://gorm.com.tr/index.php/GORM/article/view/965
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