loading page

Maternal Outcome in women with placenta previa who had antepartum haemorrhage compared to those without haemorrhage: Retrospective Cohort Study
  • +2
  • Philip Chung,
  • Kenny Cheer,
  • Eva Malacova,
  • Satomi Okan,
  • Thangeswaran Rudra
Philip Chung
Royal Brisbane and Women's Hospital

Corresponding Author:[email protected]

Author Profile
Kenny Cheer
Royal Brisbane and Women's Hospital
Author Profile
Eva Malacova
QIMR Berghofer
Author Profile
Satomi Okan
QIMR Berghofer
Author Profile
Thangeswaran Rudra
Royal Brisbane and Women's Hospital
Author Profile

Abstract

Objective: To compare maternal outcomes for placenta praevia (PP) between those who experience antepartum haemorrhage (APH) and those without APH. Design: Retrospective cohort study. Setting: Royal Brisbane & Women’s Hospital, Australia. Population: Over ten years, a total of 368 women with placenta praevia (PP) were recruited and divided into APH (n=230) and No APH (n=138). Methods: Data retrieved from institution-based obstetric database were analysed using logistic regressions for binary outcomes and Poisson or negative binomial regressions for counts. Main Outcome Measures: Type of PP, timing and mode of delivery, intra-operative and postpartum complications, volume of blood loss and number of blood transfusions. Results: Compared to women without APH, women who experienced APH had a greater proportion of major PP (OR=2.88,p<0.001), emergency lower uterine segment (OR=6.24,p<0.001) and classical (OR=14.9,p<0.001) sections, use of general anaesthesia (OR=3.14,p<0.001), preterm delivery (median 35.4 vs 38.0 weeks, p<0.001). There was no significant differences intra-operatively (number of uterotonics used or additional surgical techniques), greater volume of bloods loss (IRR=1.20,p=0.006), increased frequency of blood transfusion (IRR=3.36,p<0.001), and longer post-operative hospital stay (IRR=1.27,p=0.001). There was a total of four hysterectomies and no intensive care unit admissions or maternal deaths. Conclusions: Women with PP who experienced APH had a tendency for preterm delivery, emergency caesarean section, greater blood loss requiring more blood transfusion and longer hospital admissions. However, a lack of serious maternal morbidity among these women provides support for an individualised approach towards management of bleeding in PP. Funding: No funding body. Keywords: Antepartum Haemorrhage, Placenta Praevia, maternal outcomes.