Maternal and neonatal outcomes among scheduled versus unscheduled deliveries in women with prenatally diagnosed, pathologically proven placenta accreta

Kate E. PettitDepartment of Reproductive Medicine, University of California, San Diego, San Diego, CA, USA; ;Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA, USA; Correspondence[email protected]

Megan L. StephensonDepartment of Obstetrics and Gynecology, University of California, Irvine, Orange, CA, USA; ;Department of Obstetrics and Gynecology, Kaiser Permanente, Santa Clara, CA, USA;

Yen N. TruongDepartment of Obstetrics and Gynecology, University of California, Davis, Sacramento, CA, USA; ;Department of Obstetrics and Gynecology, Kaiser Permanente, San Leandro, CA, USA;

Dana HenryDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA;

Aisling MurphyDepartment of Obstetrics and Gynecology, University of California, Los Angeles, Los Angeles, CA, USA

Lena KimDepartment of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA;

Nancy FieldDepartment of Obstetrics and Gynecology, University of California, Davis, Sacramento, CA, USA;

Deborah A. WingDepartment of Obstetrics and Gynecology, University of California, Irvine, Orange, CA, USA;

Gladys A. RamosDepartment of Reproductive Medicine, University of California, San Diego, San Diego, CA, USA;

& for the University of California Fetal Consortium show all

Abstract

Objective: To evaluate maternal and neonatal outcomes among scheduled versus unscheduled deliveries in cases of prenatally diagnosed, pathologically proven placenta accreta.

Study design: Retrospective cohort of placenta accreta cases delivered in five University of California hospitals.

Results: Of 151 cases of histopathologically proven placenta accreta, 82% were prenatally diagnosed. Sixty-seven percent of women underwent scheduled deliveries and 33% were unscheduled. There were no differences in demographics between groups except a higher rate of antepartum bleeding in the unscheduled delivery group (81 versus 53%; p = .003). Scheduled deliveries were associated with a later gestational age at delivery (34.6 versus 32.6 weeks; p = .001), lower blood loss (2.0 versus 2.5 l; p = .04), higher birth weight (2488 versus 2010 g; p < .001), shorter postpartum length of stay (4 versus 5 d; p = .03) and neonatal length of stay (12 versus 20 d; p = .005).

Conclusion: Despite a prenatal diagnosis of placenta accreta, 1/3 of these cases require unscheduled delivery, portending poorer maternal and neonatal outcomes.

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Disclosure statement

The authors report no conflicts of interest.

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Maternal and neonatal outcomes among scheduled versus unscheduled deliveries in women with prenatally diagnosed, pathologically proven placenta accreta

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Maternal and neonatal outcomes among scheduled versus unscheduled deliveries in women with prenatally diagnosed, pathologically proven placenta accreta

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