Influence of Warning Bleeding on Blood Loss in Low-Lying Placenta

Objective This study aimed to investigate whether the amount of blood loss during delivery in patients with low-lying placenta is affected by the planned mode of delivery, internal os distance, and warning bleeding. Materials and methods We conducted a single-center retrospective study encompassing women with singleton pregnancies diagnosed with low-lying placenta between January 2012 and December 2021. Data for maternal demographic details and pregnancy outcomes were extracted from the institution's records. We analyzed blood loss during delivery according to the planned delivery mode, internal os distance (≥10 mm or within 10 mm), and the occurrence of warning bleeding. We also assessed the frequency of abnormal hemorrhage at delivery. Statistical analyses included the Mann-Whitney U test and Fisher's exact probability test, with significance set at p<0.05. Results This study included 27 pregnant women. The planned delivery mode and internal os distance showed no statistically significant impact on the amount of blood loss or frequency of abnormal hemorrhage at delivery. However, the occurrence of warning bleeding had a significant effect on both factors. Conclusion In patients diagnosed with a low-lying placenta with warning bleeding, cautious delivery management is recommended owing to the possible increased risk of abnormal hemorrhage at delivery.