Predictors Of Antepartum Hemorrhage In Patients With Placenta Previa: Antepartum Hemorrhage In Placenta Previa

Sadaf Bashir; Umbreen Idrees; Hina Ameer Chughtai; Samia Arif; Nusrat Khatoon; Saema Tehseen

doi:10.54393/pjhs.v6i1.2338

Authors

Sadaf Bashir Pakistan Air Force Hospital, Mianwali, Pakistan
Umbreen Idrees Pakistan Air Force Hospital, Islamabad, Pakistan
Hina Ameer Chughtai Pakistan Air Force Hospital, Mianwali, Pakistan
Samia Arif Pakistan Air Force Hospital, Islamabad, Pakistan
Nusrat Khatoon Fazaia Ruth Pfau Medical College, Karachi, Pakistan
Saema Tehseen Pakistan Air Force Hospital, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i1.2338

Keywords:

Antepartum Hemorrhage, Placenta Previa, Cesarean Sections, Advanced Maternal Age

Abstract

Antepartum Hemorrhage (APH) is a significant complication in pregnancy that poses serious risks to both maternal and fetal health. Objective: To find the predictors of antepartum hemorrhage in patients with placenta previa among the local population of Pakistan. Methods: This cross-sectional study was conducted at PAF Hospital Mianwali from November 2023 to April 2024. A total of 208 patients were included in the analysis. Patients diagnosed with placenta previa confirmed through ultrasound examination were included in the study. Results: The mean age of the patients was 32.83 ± 4.56 years. Out of 208, there were 60 (28.8%) and nulliparous, 148 (71.2%) were multiparous. 85 (40.9%) had previous C-section and 30 (14.4%) were suffered from hypertension. 15 (7.2%) were diabetic and 180 (86.5%) were non-smokers. APH increased by 15% (Adjusted OR: 1.15, 95% CI: 1.05-1.26, p = 0.005). Furthermore, patients with a history of previous cesarean sections had over twice the odds of developing APH compared to those without this history (Adjusted OR: 2.12, 95% CI: 1.23-3.66, p = 0.007). Conclusions: This study concluded that advanced maternal age and a history of previous cesarean sections are significant predictors of antepartum hemorrhage in patients with placenta previa.

References

King LJ, Mackeen AD, Nordberg C, Paglia MJ. Maternal risk factors associated with persistent placenta previa. Placenta. 2020 Sep; 99: 189-92. doi: 10.1016/j.placenta.2020.08.004.

Oğlak SC, Tunç Ş, Obut M, Şeker E, Behram M, Tahaoğlu AE. Maternal near-miss patients and maternal mortality cases in a Turkish tertiary referral hospital. Ginekologia Polska. 2021 Mar; 92(4): 300-5. doi: 10.5603/GP.a2020.0187.

Obut M and Oğlak SC. Retrospective evaluation of placenta previa cases: A secondary-center experince. Namık Kemal Tıp Dergisi. 2020 Aug; 8(2): 197-203. doi: 10.37696/nkmj.653185.

Feng Y, Li XY, Xiao J, Li W, Liu J, Zeng X et al. Risk factors and pregnancy outcomes: complete versus incomplete placenta previa in mid-pregnancy. Current medical science. 2018 Aug; 38: 597-601. doi: 10.1007/s11596-018-1919-9.

Gibbins KJ, Einerson BD, Varner MW, Silver RM. Placenta previa and maternal hemorrhagic morbidity. The Journal of Maternal-fetal & Neonatal Medicine. 2018 Feb; 31(4): 494-9. doi: 10.1080/14767058.2017.1289163.

Dorkham MC, Epee-Bekima MJ, Sylvester HC, White SW. Experience of Bakri balloon tamponade at a single tertiary centre: a retrospective case series. Journal of Obstetrics and Gynaecology. 2021 Aug; 41(6): 854-9. doi: 10.1080/01443615.2020.1799341.

Bahar A, Abusham A, Eskandar M, Sobande A, Alsunaidi M. Risk factors and pregnancy outcome in different types of placenta previa. Journal of Obstetrics and Gynaecology Canada. 2009 Feb; 31(2): 126-31. doi: 10.1016/S1701-2163(16)34096-8.

Jain V, Bos H, Bujold E. Guideline No. 402: diagnosis and management of placenta previa. Journal of Obstetrics and Gynaecology Canada. 2020 Jul; 42(7): 906-17. doi: 10.1016/j.jogc.2019.07.019.

Jauniaux ER, Alfirevic Z, Bhide AG, Belfort MA, Burton GJ, Collins SL et al. Placenta praevia and placenta accreta: diagnosis and management: green-top guideline no. 27a. Bjog. 2018 Dec; 126(1): e1-48. doi: 10.1111/1471-0528.15306.

Grönvall M, Stefanovic V, Paavonen J, Loukovaara M, Tikkanen M. Major or minor placenta previa: Does it make a difference?. Placenta. 2019 Sep; 85: 9-14. doi: 10.1016/j.placenta.2019.08.080.

Fadl SA, Linnau KF, Dighe MK. Placental abruption and hemorrhage-review of imaging appearance. Emergency Radiology. 2019 Feb; 26: 87-97. doi: 10.1007/s10140-018-1638-3.

Facchinetti F, Venturini P, Verocchi G, Volpe A. Comparison of two preparations of dinoprostone for pre-induction of labour in nulliparous women with very unfavourable cervical condition: a randomised clinical trial. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2005 Apr; 119(2): 189-93. doi: 10.1016/j.ejogrb.2004.06.039.

Madden N and Kominiarek MA. Nigel Madden, MD. OBG Management.;35:7.

Durukan H, Durukan ÖB, Yazıcı FG. Planned versus urgent deliveries in placenta previa: maternal, surgical and neonatal results. Archives of Gynecology and Obstetrics. 2019 Dec; 300: 1541-9. doi: 10.1007/s00404-019-05349-9.

Long SY, Yang Q, Chi R, Luo L, Xiong X, Chen ZQ. Maternal and neonatal outcomes resulting from antepartum hemorrhage in women with placenta previa and its associated risk factors: A single-center retrospective study. Therapeutics and Clinical Risk Management. 2021 Jan: 31-8. doi: 10.2147/TCRM.S288461.

Fan D, Wu S, Liu L, Xia Q, Wang W, Guo X et al. Prevalence of antepartum hemorrhage in women with placenta previa: a systematic review and meta-analysis. Scientific Reports. 2017 Jan; 7(1): 40320. doi: 10.1038/srep40320.

Kuribayashi M, Tsuda H, Ito Y, Tezuka A, Ando T, Tamakoshi K et al. Evaluation of the risk factors for antepartum hemorrhage in cases of placenta previa: a retrospective cohort study. Journal of International Medical Research. 2021 Nov; 49(11): 03000605211054706. doi: 10.1177/03000605211054706.

Cao P, Ji L, Qiao C. Nomogram based on clinical characteristics and ultrasound indicators for predicting severe postpartum hemorrhage in patients with anterior placenta previa combined with previous cesarean section: a retrospective case-control study. BioMed Central Pregnancy and Childbirth. 2024 Aug; 24(1): 572. doi: 10.1186/s12884-024-06706-6.

Zhou Y, Song Z, Wang X, Zhang M, Chen X, Zhang D. Ultrasound-based nomogram for postpartum hemorrhage prediction in pernicious placenta previa. Frontiers in Physiology. 2022 Aug; 13: 982080. doi: 10.3389/fphys.2022.982080.

Mitsuzuka K, Togo A, Nakajima R, Kanno Y, Sato K, Ishimoto H. Is cervical length a useful predictor of antepartum hemorrhage in patients with placenta previa?. Tokai Journal of Experimental and Clinical Medicine. 2022 Dec; 47(4): 204-8.