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Placenta praevia: perinatal outcomes in the experience of a third level medical unit
Francisco A Sandoval-García-Travesí1, Manuel U Reyes-Hernández1, Dolores Sandoval-Barajas2
1Servicio de Ginecología y Obstetricia, Unidad Médica de Alta Especialidad, Hospital de Ginecoobstetricia Víctor Manuel Espinosa de los Reyes Sánchez, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México.
Objective:
To describe the perinatal results of patients who underwent complicated pregnancy with anomalous insertion of the placenta.
Method:
We reviewed the clinical records with diagnosis of anomalous placental insertion after 34 weeks of gestation from January 2012 to January 2015.
Results:
200 cases were included. Diagnosis was made by endovaginal ultrasound, and 52.5% of the cases corresponded to total central placenta, 19.5% to placenta with low insertion, 18.5% to marginal placenta, and 9.5% to partial placental insertion. 24% of the pregnancies were resolved between weeks 34 and 35.6, and 76% in week 36 or more. All patients underwent cesarean: 77% were scheduled surgeries and 23% emergency surgeries. 77 patients required obstetric hysterectomy. In 58 patients, confirmed accretism by pathology. There were no maternal deaths. The most frequent complications in neonates were respiratory distress (18.5%) and newborn transitory tachypnea (5%). There was one neonatal death.
Conclusions:
Surgical treatment of anomalous placement of the placenta in third-level hospitals can prevent adverse perinatal outcomes. Expectant management is possible in selected patients.
