Maternal and neonatal outcomes of repeated antepartum bleeding in 493 placenta previa cases: a retrospective study

Abstract

Objective

To explore the effect of antepartum bleeding caused by PP on pregnancy outcomes.

Study design

We retrospectively analyzed 493 pregnant women complicated with PP. Patients were divided into antepartum repeated bleeding and non-bleeding groups. Maternal characteristics and pregnancy outcomes were compared.

Results

The risk of antepartum hemorrhage was 2.038 times higher when gravidity was 5 (95% CI 1.104–3.760, p = .023). Pregnant women with a history of more than three intrauterine procedures had a 1.968 times higher risk of antepartum hemorrhage (95% CI 1.135–3,412, p = .016) compared to pregnant women without any intrauterine procedures. The risk of antepartum bleeding was found to be decreasing with the pregnancy advancing; When the placenta edge was noted to be over cervical os, the risk of antepartum bleeding was 4.385-fold than the low-lying plcaenta cases (95%CI2.454–8.372, p = .000). In the respect of maternal outcomes, the repeated bleeding group, the risk of emergency surgery was 7.213 times higher than elective surgery (95% CI 4.402–11.817, p = .000). As for the neonatal outcomes, the risk of asphyxia was 2.970 times and the risk of neonatal intensive care unit (NICU) admission was 2.542-fold higher in repeated bleeding group compared to non-bleeding group, respectively.

Conclusions

Obstetricians should be aware of the increased risk of antepartum bleeding especially for ≤34 weeks and placenta edge over cervical os PP patients, they have a higher risk of antepartum bleeding. These women have higher possibility of emergency C-section and need preterm newborn resuscitation.

Keywords:

• Placenta previa
• antepartum bleeding
• pregnancy outcomes
• neonatal outcomes

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

All data generated or analyzed during this study are included in this published article.

Additional information

Funding

The work was supported by National Natural Science Foundation of China [81971407] in study design, Natural Science Foundation of Jiangsu Province [BK20191070] in data collection, Project on Maternal and Child Health Talents of Jiangsu Province [FRC201710] in analysis,Natural Science Research of Jiangsu Higher Education Institutions of China [18KJB320010] in interpretation of data, Jiangsu Provincial Commission of Health and Family Planning [NO. H2017020] in writing report, Jiangsu Provincial Medical Youth Talent [QNRC2016617] in decision to submit and Project 333 of Jiangsu Province [LGY2018056] in data collection.