Volume 1, Issue 2

 

Pregnancy Outcome in Patients with “Corrected” Mid-Trimester Placenta Previa

August 2, 2010

Background:

Placenta Previa, defined as placental implantation over the internal cervical os, occurs in 1 in 300 live births.

 Figure 1. Depiction of Normal Gestation (left) versus uncorrected Placenta previa ( right). Note location of placenta in relationship to cervix

  • At mid-trimester, evidence of placental tissue covering the cervical os will be found in 5 -15% of patients. Approximately 90% of these cases resolve to a normal position at term.  
  • An increased risk of perinatal and neonatal complications has been reported in patients with “corrected” mid-trimester placenta previa. 
  • The exact reasons for adverse pregnancy outcome associated with corrected mid-trimester placenta previa are not clearly understood.

 

Objective:

  • To assess pregnancy outcomes in patients with “corrected” mid- trimester placenta previa in order to determine what effects if any this condition imposes on maternal and infant welfare.

 

Study Group:

 43 patients presenting with corrected mid-

trimester placenta previa compared to control group of 29

normal gestations within same time period…

  

Methods:

  • We reviewed our experience with a series of 43 women presenting with “corrected” mid-trimester placenta previa and compared them to a randomly selected control group of similar patients (n=29) who did not have mid-trimester placenta previa from the same perinatal registry within the same period.
  • Outcome Measures:
    •   Premature Rupture of Membranes
    •   Placental Abruption
    •   Preterm Delivery
    •   Hemorrhage
    •   Congenital Anomalies
    •   Apgar Scores
    •   Birthweight

  Results:

 

 

 

Conclusion:

  • The risk of perinatal complications in “corrected” mid trimester placenta previa remains high despite conversion of placenta to a normal position.
  • Management of these patients therefore requires close attention to hematological status pre-delivery as this presented the greatest risk for postpartum morbidity.