Placenta praevia without antepartum haemorrhage

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine

Background:

• Placenta previa is a significant obstetric complication.
• Antepartum hemorrhage is a common concern in placenta previa cases.
• Timely diagnosis of placenta previa is crucial for optimal maternal and fetal outcomes.

Purpose of the Study:

• To determine the incidence of placenta previa in a large patient cohort.
• To investigate the occurrence of antepartum hemorrhage in patients diagnosed with placenta previa.
• To analyze the timing of placenta previa diagnosis in relation to delivery method and antepartum bleeding.

Main Methods:

• Retrospective analysis of 26,155 patient records.
• Identification of placenta previa cases and associated antepartum hemorrhage.
• Categorization of diagnosis timing (pre-delivery, post-vaginal delivery, during Cesarean section).

Main Results:

• The incidence of placenta previa was 0.9% (238 cases).
• Of 238 placenta previa patients, 81 (34%) had no antepartum hemorrhage.
• Among those without antepartum hemorrhage, diagnosis occurred post-vaginal delivery (17 cases) or at Cesarean section (52 cases).
• Approximately 40% of women with placenta previa who delivered vaginally experienced no antepartum bleeding.

Conclusions:

• A significant proportion of placenta previa cases may not present with antepartum bleeding.
• The absence of antepartum hemorrhage can delay the diagnosis of placenta previa.
• Clinical awareness and diagnostic vigilance are essential, even in the absence of bleeding.