Araştırma Makalesi
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Plasenta Previalı Gebelerin Obstetrik Sonuçları; Retrospektif Karşılaştırmalı Çalışma

Yıl 2022, Cilt 11, Sayı 1, 144 - 152, 19.03.2022
https://doi.org/10.37989/gumussagbil.1052393

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.

Kaynakça

  • 1. Sekiguchi, A, Nakai, A, Kawabata, I, Hayashi, M. and Takeshita, T. (2013). “Type and Location of Placenta Previa Affect Preterm Delivery Risk Related to Antepartum Hemorrhage”. Int J Med Sci, 10 (12), 1683-1688.
  • 2. Yeniel, A.O, Ergenoglu, A.M, Itil, I.M, Askar, N. and Meseri, R. (2012). “Effect of Placenta Previa on Fetal Growth Restriction and Stillbirth”. Arch Gynecol Obstet, 286 (2), 295-298.
  • 3. Erez, O, Novack, L, Klaitman, V, Erez-Weiss, I, Beer-Weisel, R, Dukler, D. and Mazor, M. (2012). “Early Preterm Delivery Due to Placenta Previa Is An Independent Risk Factor for A Subsequent Spontaneous Preterm Birth”. BMC Pregnancy Childbirth, 12, 82-87.
  • 4. Hasegawa, J, Nakamura, M, Hamada, S, Matsuoka, R, Ichizuka, K, Sekizawa, A. and Okai, T. (2012). “Prediction of Hemorrhage in Placenta Previa”. Taiwan J Obstet Gynecol, 51 (1), 3-6.
  • 5. Blackwell, S.C. (2011). “Timing of Delivery for Women with Stable Placenta Previa”. Semin Perinatol, 35 (5), 249-251.
  • 6. Sharma, A, Suri, V. and Gupta, I. (2004). “Tocolytic Therapy in Conservative Management of Symptomatic Placenta Previa”. Int J Gynaecol Obstet, 84 (2), 109-113.
  • 7. Daskalakisi, G, Simou, M, Zacharakis, D, Detorakis, S, Akrivos, N, Papantoniou, N, Fouskakis, D. and Antsaklis, A. (2011). “Impact of Placenta Previa on Obstetric Outcome”. Int J Gynaecol Obstet, 114 (3), 238-241.
  • 8. Brecher, M.E, Monk, T. and Goodnough, LT. (1997). “A Standardized Method for Calculating Blood Loss”. Transfusion, 37 (10), 1070-1074.
  • 9. Fawzy, AEMA, Swelem, M, Abdelrehim, A.I, Titeli, S, Elghazal, Z.S. and El-Gahwagi, M.M. and Ben Amour, A.S. (2012). “Active Management of Third Stage of Labor by Intravenous Ergometrine and Rectal Versus Sublingual Misoprostol (A Double-Center Study)”. Alexandria Med J, 48 (4), 381-385.
  • 10. Lahoria, K, Malhotra, S. and Bagga, R. (2007). “Transabdominal and Transvaginal Ultrasonography of Placenta Previa”. Int J Gynaecol Obstet, 98 (3), 258-259.
  • 11. Arduini, M, Epicoco, G, Clerici, G, Bottaccioli, E, Arena, S. and Affronti, G. (2010). “B-Lynch Suture, Intrauterine Balloon, and Endouterine Hemostatic Suture for The Management of Postpartum Hemorrhage Due To Placenta Previa Accreta”. Int J Gynaecol Obstet, 108 (3), 191-193.
  • 12. Hasegawa, J, Higashi, M, Takahashi, S, Mimura, T, Nakamura, M, Matsuoka, R, Ichizuka, K, Sekizawa, A. and Okai, T. (2011). “Can Ultrasonography of The Placenta Previa Predict Antenatal Bleeding?”. J Clin Ultrasound, 39, 458-462.
  • 13. Hsu, T.Y. (2009). “Abnormal Invasive Placentation-Placenta Previa Increta and Percreta”. Taiwan J Obstet Gynecol, 48, 1-2.
  • 14. Daglar, K, Tokmak, A, Kirbas, A, Kara, O, Timur, H. and Uygur, D. (2016). “Risk Factors for Hysterectomy among Patients with Placenta Previa Totalis”. Proceedings in Obstetrics and Gynecology, 2, 1-10.
  • 15. Portilla, D, Hernández-Giraldo, C, Moreno, B, Quijano, F, Hoyos, L.R, Angarita, A.M. and Madero, S.A. (2013). “Local Hemostatic Agent for the Management of Postpartum Hemorrhage Due To Placenta Previa and Placenta Accreta: A Cross-Sectional Study”. Arch Gynecol Obstet, 288 (3), 543-539.
  • 16. Yang, M.J. and Wang, P.H. (2010). “Peripartum Hysterectomy Risk Factors in Taiwan”. J Chin Med Assoc, 73, 399-400.
  • 17. Ge, J, Liao, H, Duan, L, Wei, Q. and Zeng, W. (2012). “Uterine Packing During Cesarean Section in The Management of Intractable Hemorrhage in Central Placenta Previa”. Arch Gynecol Obstet, 285 (2), 285-289.
  • 18. Jones, B, Zhang, E, Alzouebi, A, Robbins, T, Paterson-Brown, S, Prior, T. and Kumar, S. (2013). “Maternal and Perinatal Outcomes Following Peripartum Hysterectomy from A Single Tertiary Canter”. Aust N Z J Obstet Gynaecol, 53 (6), 561-565.
  • 19. Huang, Y.Y, Zhuang, J.Y, Bao, Y.R, Ying, H. and Wang, D.F. (2012). “Use of Early Transverse Annular Compression Sutures for Complete Placenta Previa During Cesarean Delivery”. Int J Gynaecol Obstet, 119 (3), 221-223.
  • 20. Hasegawa, J, Matsuoka, R, Ichizuka, K, Mimura, T, Sekizawa, A, Farina, A. and Okai, T. (2009). “Predisposing Factors for Massive Hemorrhage During Cesarean Section in Patients with Placenta Previa”. Ultrasound Obstet Gynecol, 34, 80-84.
  • 21. Bakri, Y.N, Amir, A. and Abdul Jabbar, F. (2001). “Tamponade-Balloon for Obstetrical Bleeding”. Int J Gynecol Obstet, 74, 139-142.
  • 22. Jin, R, Guo, Y. and Chen, Y. (2014). “Risk Factors Associated with Emergency Peripartum Hysterectomy”. Chin Med J, 127 (5), 900-904.
  • 23. Awan, N, Bennett, M.J. and Walters, W.A. (2011). “Emergency Peripartum Hysterectomy: A 10-Year Review at the Royal Hospital for Women, Sydney”. Aust N Z J Obstet Gynaecol, 51 (3), 210-215.
  • 24. O'Brien, D, Babiker, E, O'Sullivan, O, Conroy, R, McAuliffe, F, Geary, M. and Byrne, B. (2010). “Prediction of Peripartum Hysterectomy and End Organ Dysfunction in Major Obstetric Haemorrhage”. Eur J Obstet Gynecol Reprod Biol, 153 (2), 165-169.
  • 25. Ananth, C.V, Smulian, J.C. and Vintzileos, A.M. (2003). “The Effect of Placenta Previa on Neonatal Mortality: A Population-Based Study in the United States, 1989 through 1997”. Am J Obstet Gynecol, 188 (5), 1299-1304.

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

Yıl 2022, Cilt 11, Sayı 1, 144 - 152, 19.03.2022
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.

Kaynakça

  • 1. Sekiguchi, A, Nakai, A, Kawabata, I, Hayashi, M. and Takeshita, T. (2013). “Type and Location of Placenta Previa Affect Preterm Delivery Risk Related to Antepartum Hemorrhage”. Int J Med Sci, 10 (12), 1683-1688.
  • 2. Yeniel, A.O, Ergenoglu, A.M, Itil, I.M, Askar, N. and Meseri, R. (2012). “Effect of Placenta Previa on Fetal Growth Restriction and Stillbirth”. Arch Gynecol Obstet, 286 (2), 295-298.
  • 3. Erez, O, Novack, L, Klaitman, V, Erez-Weiss, I, Beer-Weisel, R, Dukler, D. and Mazor, M. (2012). “Early Preterm Delivery Due to Placenta Previa Is An Independent Risk Factor for A Subsequent Spontaneous Preterm Birth”. BMC Pregnancy Childbirth, 12, 82-87.
  • 4. Hasegawa, J, Nakamura, M, Hamada, S, Matsuoka, R, Ichizuka, K, Sekizawa, A. and Okai, T. (2012). “Prediction of Hemorrhage in Placenta Previa”. Taiwan J Obstet Gynecol, 51 (1), 3-6.
  • 5. Blackwell, S.C. (2011). “Timing of Delivery for Women with Stable Placenta Previa”. Semin Perinatol, 35 (5), 249-251.
  • 6. Sharma, A, Suri, V. and Gupta, I. (2004). “Tocolytic Therapy in Conservative Management of Symptomatic Placenta Previa”. Int J Gynaecol Obstet, 84 (2), 109-113.
  • 7. Daskalakisi, G, Simou, M, Zacharakis, D, Detorakis, S, Akrivos, N, Papantoniou, N, Fouskakis, D. and Antsaklis, A. (2011). “Impact of Placenta Previa on Obstetric Outcome”. Int J Gynaecol Obstet, 114 (3), 238-241.
  • 8. Brecher, M.E, Monk, T. and Goodnough, LT. (1997). “A Standardized Method for Calculating Blood Loss”. Transfusion, 37 (10), 1070-1074.
  • 9. Fawzy, AEMA, Swelem, M, Abdelrehim, A.I, Titeli, S, Elghazal, Z.S. and El-Gahwagi, M.M. and Ben Amour, A.S. (2012). “Active Management of Third Stage of Labor by Intravenous Ergometrine and Rectal Versus Sublingual Misoprostol (A Double-Center Study)”. Alexandria Med J, 48 (4), 381-385.
  • 10. Lahoria, K, Malhotra, S. and Bagga, R. (2007). “Transabdominal and Transvaginal Ultrasonography of Placenta Previa”. Int J Gynaecol Obstet, 98 (3), 258-259.
  • 11. Arduini, M, Epicoco, G, Clerici, G, Bottaccioli, E, Arena, S. and Affronti, G. (2010). “B-Lynch Suture, Intrauterine Balloon, and Endouterine Hemostatic Suture for The Management of Postpartum Hemorrhage Due To Placenta Previa Accreta”. Int J Gynaecol Obstet, 108 (3), 191-193.
  • 12. Hasegawa, J, Higashi, M, Takahashi, S, Mimura, T, Nakamura, M, Matsuoka, R, Ichizuka, K, Sekizawa, A. and Okai, T. (2011). “Can Ultrasonography of The Placenta Previa Predict Antenatal Bleeding?”. J Clin Ultrasound, 39, 458-462.
  • 13. Hsu, T.Y. (2009). “Abnormal Invasive Placentation-Placenta Previa Increta and Percreta”. Taiwan J Obstet Gynecol, 48, 1-2.
  • 14. Daglar, K, Tokmak, A, Kirbas, A, Kara, O, Timur, H. and Uygur, D. (2016). “Risk Factors for Hysterectomy among Patients with Placenta Previa Totalis”. Proceedings in Obstetrics and Gynecology, 2, 1-10.
  • 15. Portilla, D, Hernández-Giraldo, C, Moreno, B, Quijano, F, Hoyos, L.R, Angarita, A.M. and Madero, S.A. (2013). “Local Hemostatic Agent for the Management of Postpartum Hemorrhage Due To Placenta Previa and Placenta Accreta: A Cross-Sectional Study”. Arch Gynecol Obstet, 288 (3), 543-539.
  • 16. Yang, M.J. and Wang, P.H. (2010). “Peripartum Hysterectomy Risk Factors in Taiwan”. J Chin Med Assoc, 73, 399-400.
  • 17. Ge, J, Liao, H, Duan, L, Wei, Q. and Zeng, W. (2012). “Uterine Packing During Cesarean Section in The Management of Intractable Hemorrhage in Central Placenta Previa”. Arch Gynecol Obstet, 285 (2), 285-289.
  • 18. Jones, B, Zhang, E, Alzouebi, A, Robbins, T, Paterson-Brown, S, Prior, T. and Kumar, S. (2013). “Maternal and Perinatal Outcomes Following Peripartum Hysterectomy from A Single Tertiary Canter”. Aust N Z J Obstet Gynaecol, 53 (6), 561-565.
  • 19. Huang, Y.Y, Zhuang, J.Y, Bao, Y.R, Ying, H. and Wang, D.F. (2012). “Use of Early Transverse Annular Compression Sutures for Complete Placenta Previa During Cesarean Delivery”. Int J Gynaecol Obstet, 119 (3), 221-223.
  • 20. Hasegawa, J, Matsuoka, R, Ichizuka, K, Mimura, T, Sekizawa, A, Farina, A. and Okai, T. (2009). “Predisposing Factors for Massive Hemorrhage During Cesarean Section in Patients with Placenta Previa”. Ultrasound Obstet Gynecol, 34, 80-84.
  • 21. Bakri, Y.N, Amir, A. and Abdul Jabbar, F. (2001). “Tamponade-Balloon for Obstetrical Bleeding”. Int J Gynecol Obstet, 74, 139-142.
  • 22. Jin, R, Guo, Y. and Chen, Y. (2014). “Risk Factors Associated with Emergency Peripartum Hysterectomy”. Chin Med J, 127 (5), 900-904.
  • 23. Awan, N, Bennett, M.J. and Walters, W.A. (2011). “Emergency Peripartum Hysterectomy: A 10-Year Review at the Royal Hospital for Women, Sydney”. Aust N Z J Obstet Gynaecol, 51 (3), 210-215.
  • 24. O'Brien, D, Babiker, E, O'Sullivan, O, Conroy, R, McAuliffe, F, Geary, M. and Byrne, B. (2010). “Prediction of Peripartum Hysterectomy and End Organ Dysfunction in Major Obstetric Haemorrhage”. Eur J Obstet Gynecol Reprod Biol, 153 (2), 165-169.
  • 25. Ananth, C.V, Smulian, J.C. and Vintzileos, A.M. (2003). “The Effect of Placenta Previa on Neonatal Mortality: A Population-Based Study in the United States, 1989 through 1997”. Am J Obstet Gynecol, 188 (5), 1299-1304.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Araştırma Makaleleri
Yazarlar

Burcu TİMUR (Sorumlu Yazar)
Ordu Üniversitesi Eğitim ve Araştırma Hastanesi
0000-0001-8769-5949
Türkiye

Yayımlanma Tarihi 19 Mart 2022
Yayınlandığı Sayı Yıl 2022, Cilt 11, Sayı 1

Kaynak Göster

Bibtex @araştırma makalesi { gumussagbil1052393, journal = {Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi}, eissn = {2146-9954}, address = {}, publisher = {Gümüşhane Üniversitesi}, year = {2022}, volume = {11}, number = {1}, pages = {144 - 152}, doi = {10.37989/gumussagbil.1052393}, title = {Obstetric Outcomes of Pregnant Women with Placenta Previa: A Retrospective Comparative Study}, key = {cite}, author = {Timur, Burcu} }
APA Timur, B. (2022). Obstetric Outcomes of Pregnant Women with Placenta Previa: A Retrospective Comparative Study . Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi , 11 (1) , 144-152 . DOI: 10.37989/gumussagbil.1052393
MLA Timur, B. "Obstetric Outcomes of Pregnant Women with Placenta Previa: A Retrospective Comparative Study" . Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 11 (2022 ): 144-152 <https://dergipark.org.tr/tr/pub/gumussagbil/issue/68960/1052393>
Chicago Timur, B. "Obstetric Outcomes of Pregnant Women with Placenta Previa: A Retrospective Comparative Study". Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 11 (2022 ): 144-152
RIS TY - JOUR T1 - Obstetric Outcomes of Pregnant Women with Placenta Previa: A Retrospective Comparative Study AU - Burcu Timur Y1 - 2022 PY - 2022 N1 - doi: 10.37989/gumussagbil.1052393 DO - 10.37989/gumussagbil.1052393 T2 - Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi JF - Journal JO - JOR SP - 144 EP - 152 VL - 11 IS - 1 SN - -2146-9954 M3 - doi: 10.37989/gumussagbil.1052393 UR - https://doi.org/10.37989/gumussagbil.1052393 Y2 - 2022 ER -
EndNote %0 Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi Obstetric Outcomes of Pregnant Women with Placenta Previa: A Retrospective Comparative Study %A Burcu Timur %T Obstetric Outcomes of Pregnant Women with Placenta Previa: A Retrospective Comparative Study %D 2022 %J Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi %P -2146-9954 %V 11 %N 1 %R doi: 10.37989/gumussagbil.1052393 %U 10.37989/gumussagbil.1052393
ISNAD Timur, Burcu . "Obstetric Outcomes of Pregnant Women with Placenta Previa: A Retrospective Comparative Study". Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 11 / 1 (Mart 2022): 144-152 . https://doi.org/10.37989/gumussagbil.1052393
AMA Timur B. Obstetric Outcomes of Pregnant Women with Placenta Previa: A Retrospective Comparative Study. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2022; 11(1): 144-152.
Vancouver Timur B. Obstetric Outcomes of Pregnant Women with Placenta Previa: A Retrospective Comparative Study. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2022; 11(1): 144-152.
IEEE B. Timur , "Obstetric Outcomes of Pregnant Women with Placenta Previa: A Retrospective Comparative Study", Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, c. 11, sayı. 1, ss. 144-152, Mar. 2022, doi:10.37989/gumussagbil.1052393