Obstetric Outcomes of Pregnant Women with Placenta Previa: A Retrospective Comparative Study

Yıl 2022, , 144 - 152, 19.03.2022

Burcu Timur

https://doi.org/10.37989/gumussagbil.1052393

Öz

Placenta previa (PP) is one of the leading causes of severe peripartum complications that resulting in serious maternal and perinatal morbidity such as peripartum hemorrhage and preterm delivery. Herein, we aimed to compare obstetric outcomes of pregnant women with PP versus pregnant women without PP in our hospital. This retrospective case-control study was conducted on 179 pregnant women in the study group (PP group) and 626 in the control group. Outcome measures included demographic and clinical characteristics of both groups, chief complaints on admission, gestational age at birth, postpartum hemorrhage, interventional modalities to treat postpartum hemorrhage and emergency peripartum hysterectomy. Maternal age (p<0.001), parity (p<0.002) and prior abortus (p<0.001) were greater in the PP group. The chief symptom present on admission was vaginal bleeding, 53% in the study group, and pelvic pain, 50% in the control group. Median birth week (p<0.001), median birth weight (p< 0.001), and mean hemoglobin level (p=0.005) were lower in the study group. Early preterm birth (<34 weeks) rate and late preterm birth (between 34 and 37 weeks) rate were greater in the study group (both p<0.001). Term birth rate (≥ 37 weeks) was greater in the control group (p<0.001). Postpartum hemorrhage rate (p<0.001), blood product transfusion rate (p<0.001), uterine atony rate (p<0.001), and emergency postpartum hysterectomy rate (p<0.001) were greater in the study group. PP leads to worsening of obstetric outcomes, particularly increased maternal morbidities and premature delivery. Obstetricians should be familiar with diagnoses, complications and management of PP for appropriate and timely intervention. Pregnant women with PP should be close follow-up to decrease maternal morbidity and mortality.

Anahtar Kelimeler

maternal morbidity, obstetric labor complications, peripartum hysterectomy, postpartum hemorrhage, preterm delivery

Plasenta Previalı Gebelerin Obstetrik Sonuçları; Retrospektif Karşılaştırmalı Çalışma

Öz

Plasenta previa (PP), peripartum kanama ve erken doğum gibi ciddi maternal ve perinatal morbiditeye neden olan, ciddi peripartum komplikasyonların önde gelen nedenlerinden biridir. Burada hastanemizde PP'li gebelerle PP'siz gebelerin obstetrik sonuçlarını karşılaştırmayı amaçladık. Bu retrospektif vaka-kontrol çalışmasına Ordu Üniversitesi ve Zekai Tahir Burak Eğitim ve Araştırma Hastanesi, Ordu, Ankara'da doğum yapan gebeler dahil edildi. Çalışma grubunda 179, kontrol grubunda 626 gebe bulunmaktadır. Sonuç ölçütleri, her iki grubun demografik ve klinik özelliklerini, başvurudaki başlıca şikayetleri, doğumdaki gebelik yaşını, doğum sonu kanamayı, doğum sonu kanamayı tedavi etmek için girişimsel modaliteleri ve acil peripartum histerektomiyi içermiştir. Anne yaşı (p<0,001), parite (p<0,002) ve önceki abortus (p<0,001) PP grubunda daha fazlaydı. Başvuru sırasında mevcut olan başlıca semptom, çalışma grubunda %53 oranında vajinal kanama ve kontrol grubunda %50 oranında pelvik ağrıydı. Ortanca doğum haftası (p<0,001), ortanca doğum ağırlığı (p< 0,001) ve ortalama hemoglobin düzeyi (p=0,005) çalışma grubunda daha düşüktü. Erken erken doğum (<34 hafta) ve geç erken doğum (34-37 hafta) oranı çalışma grubunda daha fazlaydı (her ikisi de p<0,001). Dönem doğum oranı (≥ 37 hafta) kontrol grubunda daha fazlaydı (p<0,001). PP grubunda doğum sonu kanama oranı (p<0,001), kan ürünü transfüzyon oranı (p<0,001), uterus atoni oranı (p<0,001) ve acil doğum sonu histerektomi oranı (p<0,001) daha yüksektir. PP, özellikle artan maternal morbiditeler ve erken doğum olmak üzere obstetrik sonuçların kötüleşmesine yol açmaktadır. Doğum uzmanları, uygun ve zamanında müdahale için PP'nin tanılarına, komplikasyonlarına ve yönetimine aşina olmalıdır. PP'li gebeler maternal morbidite ve mortaliteyi azaltmak için yakın takip edilmelidir.

Anahtar Kelimeler

Maternal morbidite, Postpartum hemoraji, Peripartum histerektomi, Preterm Doğum, Obstetrik doğum komplikasyonları

Kaynakça

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