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Risk Factors for Antepartum Haemorrhage in Women With Placenta Praevia
A Treffers1, O Reynoldson1, M Beckmann1
1Obstetrics and Gynaecology, Mater Mothers Hospital, Brisbane, Queensland, Australia.
The Australian & New Zealand Journal of Obstetrics & Gynaecology
|January 2, 2025
Summary
Placenta praevia (PP) can cause antepartum haemorrhage (APH). Multiparous Caucasian women with major PP face higher APH admission and premature delivery risks, guiding clinical decisions.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Clinical Risk Factor Analysis
Background:
- Placenta praevia (PP) is a major obstetric complication linked to antepartum haemorrhage (APH), posing risks to mothers and fetuses.
- Identifying APH risk factors in PP patients is crucial for effective management strategies.
Purpose of the Study:
- To identify risk factors associated with antepartum haemorrhage (APH) in women diagnosed with placenta praevia (PP).
Main Methods:
- Retrospective cohort study of 430 women with PP after 24 weeks gestation (2007-2021).
- Data analysis included bivariate and stepwise logistic regression to identify independent risk factors for APH.
- Exclusions: multiple pregnancies, fetal abnormalities, intrauterine fetal death, and deliveries at other hospitals.
Main Results:
- 112 (26%) women with PP were admitted with APH; 40% of these had multiple admissions.
- APH admission was associated with earlier gestation delivery and neonatal nursery admission.
- Independent risk factors for APH included: increased previous caesarean sections, higher parity, Caucasian ethnicity, and major PP.
Conclusions:
- While most PP cases do not require APH admission, specific patient groups are at higher risk.
- Multiparous Caucasian women with major PP are identified as a higher-risk group for APH admission and premature delivery.
- Findings emphasize the need for individualized clinical decision-making in managing PP patients.
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