https://orcid.org/0000-0003-2017-5353
Abstract
Background
To compare the maternal and neonatal outcomes of placenta previa (PP) with and without coverage of a uterine scar in Foshan, China.
Methods
A retrospective cohort study comparing all singleton pregnancies with PP was conducted at a tertiary, university-affiliated medical center from 1 January 2012 to 31 April 2017 in Foshan, China. Demographic, clinical and laboratory data were extracted from electronic medical records (EMRs). Maternal and neonatal outcomes of PP with and without coverage of a uterine scar were compared by statistical method.
Results
There were 58,062 deliveries during the study period, of which 726 (1.25%) were complicated PP in singleton pregnancies and were further classified into two groups: the PP with coverage of a uterine scar group (PPCS, n=154) and the PP without coverage of a uterine scar group (Non-PPCS, n=572). Overall, premature birth (<37 weeks, 67.5% vs 54.8%; P=0.019), cesarean section (100% vs 97.6%; P=0.050), intraoperative blood loss >1000 mL (77.9% vs 16.0%; P<0.001) or >3000mL (29.9% vs 3.0%; P<0.001), bleeding within 2-24 hours after delivery (168.2±370.1 ml vs 49.9±58.4 ml; P<0.001), postpartum hemorrhage (48.7% vs 15.7%; P<0.001), transfusion (34.6% vs 16.1%; P<0.001), hemorrhage shock (7.8% vs 1.9%; P<0.001), hysterectomy (2.6% vs 0.5%; P=0.019), fetal distress (35.7% vs 12.1%; P<0.001) and APGAR score at 1 min (15.2% vs 7.1%; P=0.002) had a significant difference between PPCS group and Non-PPCS group. After grouping by whether complicated with placenta accreta spectrum disorders (PASD), we found that PPCS was significant associated with more intraoperative blood loss >1000mL, intraoperative blood loss >3000mL, bleeding within 2–24 hours after delivery and fetal distress than the Non-PPCS group.
Conclusion
The PPCS group had poorer maternal and neonatal outcomes than the Non-PPCS group after grouping by whether pregnancies complicated with PASD or with different placental positions.
Data Sharing Statement
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Acknowledgments
We would like to thank Qili Yang and Xiaoli Li in data collection. The authors would like to thank all medical staff for their collaboration in clinical practice, particularly during data collection.
Author Contributions
JR designed and implemented the study, conducted data analysis and write the manuscript; FD, ZZ, LX, MH, WY, SX, LD and ZH designed the statistical analysis and help with data analysis; FD helped with analysis plan and result interpretation; LY and LZ designed the study and developed the manuscript. All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.
Disclosure
The authors have no conflicts of interest relevant to this article.