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Acute and massive bleeding from placenta previa and infants' brain damage
Ken Furuta1, Shuichi Tokunaga1, Seishi Furukawa1
1Department of Obstetrics and Gynecology, Center for Perinatal Medicine, University of Miyazaki, Faculty of Medicine, Miyazaki, Japan.
Early Human Development
|July 8, 2014
Summary
Massive bleeding from placenta previa (placental bleeding) around 30 weeks may increase the risk of cerebral palsy (CP) in infants. Further research is needed to understand this connection and guide neonatal care.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Neurology
- Perinatal Medicine
Background:
- The link between third-trimester bleeding due to placenta previa and the development of cerebral palsy (CP) is not well-established.
- Understanding this association is crucial for improving perinatal outcomes.
Purpose of the Study:
- To investigate the effect of maternal bleeding from placenta previa on infant cerebral palsy.
- To determine the timing and mechanisms by which placenta previa-related bleeding may impact CP development.
Main Methods:
- A descriptive, population-based study analyzing 160,000 deliveries between 1998 and 2012.
- Focused on 60 infants born to mothers with placenta previa, excluding preterm births before 26 weeks and cases of placenta accreta.
- Assessed the prevalence of cystic periventricular leukomalacia (PVL) and cerebral palsy (CP) as outcome measures.
Main Results:
- Five infants developed PVL, with four subsequently diagnosed with CP (a rate of 1 in 40,000 deliveries).
- Acute, massive bleeding (>500g within 8 hours) occurred around 30-31 weeks of gestation, necessitating preterm delivery.
- Infants with PVL did not show typical signs of fetal distress like acidemia, abnormal heart rate, or hypotension, but none received antenatal corticosteroids.
Conclusions:
- Acute, massive bleeding associated with placenta previa in the third trimester may be a risk factor for CP.
- Neonatal follow-up is essential for infants exposed to significant placental bleeding.
- Further research is required to elucidate the pathophysiological link between massive placental bleeding and PVL.
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