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Risk factors for preterm delivery with placenta previa
Shira G Fishman1, Stephen T Chasen, Bani Maheshwari
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA. sgf2001@med.cornell.edu
Journal of Perinatal Medicine
|November 17, 2011
Summary
Antepartum bleeding in pregnancies with placenta previa is a strong predictor of preterm delivery. This finding highlights the importance of monitoring bleeding events for timely intervention and improved outcomes.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Perinatology
Background:
- Placenta previa is a condition where the placenta partially or completely covers the cervix.
- Preterm delivery (before 37 weeks of gestation) poses significant risks to both mother and infant.
- Identifying predictors of preterm birth in placenta previa cases is crucial for management.
Purpose of the Study:
- To determine factors associated with preterm delivery in pregnancies diagnosed with placenta previa via ultrasound.
- To evaluate the predictive value of antepartum bleeding for preterm birth in this population.
Main Methods:
- Retrospective analysis of 113 singleton pregnancies with sonographically identified placenta previa at ≥28 weeks.
- Extraction of demographic, antepartum, and delivery data from electronic medical records.
- Statistical analysis using Fisher's exact test, Mann-Whitney U, Spearman's ρ, and logistic regression.
Main Results:
- Nearly half (52%) of pregnancies with placenta previa resulted in preterm delivery.
- Antepartum bleeding occurred in 45% of cases, with a median onset at 31 weeks.
- Antepartum bleeding before 34 weeks strongly predicted preterm birth (88% PPV) and emergent delivery (83% PPV).
Conclusions:
- Antepartum bleeding is a significant predictor of preterm delivery in pregnancies complicated by placenta previa.
- Early bleeding events are associated with a higher likelihood of emergent delivery due to hemorrhage.
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