Maternal and Neonatal Outcomes of Placenta Previa with and without Coverage of a Uterine Scar: A Retrospective Cohort Study in a Tertiary Hospital

Figures & data

Figure 1 Flow chart of the study population.

Table 1 Comparison of Baseline Characteristics of Patients with PPCS and Non-PPCS

Characteristics	Total (n=726)	PPCS (n=154)	Non-PPCS (n=572)	P value
Maternal age mean ± SD, y	31.71±5.25 [16–48]	32.50±4.88 [21–43]	31.48±5.33 [16–48]	0.027*
Maternal BMI^a mean ± SD	26.06±3.11 [17.31–39.96]	26.49±3.35 [19.44–38.05]	25.93±3.03 [17.31–39.96]	0.041*
Gestational weeks mean ± SD	35.70±2.46 [28–41]	35.72±2.25 [28–41]	35.84±2.39 [28–41]	0.530
Race/ethnicity (%)				0.925
Han Chinese	716(98.6)	152(98.7)	564(98.6)
National minority	10(1.4)	2(1.3)	8(1.4)
BMI at delivery (%)				0.327
<24	183(25.2)	32(20.8)	151(26.4)
24 to 28	365(50.3)	80(51.9)	285(49.8)
>28	178(24.5)	42(27.3)	136(23.8)
Parity (%)				<0.001*
1	229(31.5)	0(0)	229(40.0)
2	401(55.2)	126(81.8)	275(48.1)
3	85(11.7)	25(16.2)	60(10.5)
≥4	11(1.5)	3(1.9)	8(1.4)
Prior CS (%)				<0.001*
No	482(66.4)	0	482(84.3)
Yes	244(33.6)	154(100)	90(15.7)
IVF-ET (%)				0.059
No	666(91.7)	147(95.5)	519(90.7)
Yes	60(8.3)	7(4.5)	53(9.3)
HDCP				0.078
No	704(97.0)	146(94.8)	558(97.6)
Yes	22(3.0)	8(5.2)	14(2.4)
GDM				0.785
No	604(83.2)	127(82.5)	477(83.4)
Yes	122(16.8)	27(17.5)	95(16.6)

Notes: Data are mean±SD (independent t-test) or n (%) (x² test); *P < 0.05. Percentages do not total 100% owing to missing data.

Abbreviations: n, number of observations; SD, standard deviation; ^aBMI at delivery, body mass index at delivery; HDCP, hypertensive disorder complicating pregnancy; GDM, gestational diabetes mellitus; CS, cesarean section; IVF-ET, in vitro fertilization and embryo transfer.

Table 2 Comparison of PASD and Placenta Position in Patients in the PPCS and Non-PPCS Groups

PASD	Total (n=726)	PPCS (n=154)	Non-PPCS (n=572)	P value
With PASD	144(19.9)	72(46.8)	72(12.6)	<0.001*
Placenta accreta	54(7.5)	14(9.1)	40(7.0)
Placenta increta or percreta	90 (12.4)	58(37.7)	32(5.6)
Placenta position				<0.001*
Anterior	197(27.1)	72(46.8)	125(21.9)
Posterior	352(48.5)	30(19.5)	322(56.3)
Ante-posterior or laterally positioned	177(24.4)	52(33.8)	125(21.9)

Notes: Percentages do not total 100% owing to missing data. *P < 0.05

Table 3 Comparison of Pregnancy Outcomes with and without PASD in Patients with PPCS and Non-PPCS

Maternal/Neonatal Outcomes	All (n=726)			P-value	With PASD (n=144)		P-value	Without PASD (n=582)		P -value
	PPCS (n=154)	Non-PPCS (n=572)			PPCS (n=72)	Non-PPCS (n=72)		PPCS (n=82)	Non-PPCS (n=500)
Maternal
Gestational weeks				0.019*			0.630			0.315
28–36	102(67.5)		312(54.8)		53(74.6)	48(67.6)		49(61.3)	264(53.0)
37–39	46(30.5)		240(42.2)		16(22.5)	21(29.6)		30(37.5)	219(44.0)
> 40	3(2.0)		17(3.0)		2(2.8)	2(2.8)		1(1.3)	15(3.0)
Mode of delivery				0.050*			-			0.125
Vaginal	0		14(2.4)		0	0		0	14(2.8)
Cesarean section	154(100.0)		558(97.6)		79(100.0)	72(100.0)		87(100.0)	486(97.2)
Intraoperative blood loss> 1000 mL	120(77.9)		91(16.0)	<0.001*	65(90.3)	29(40.8)	<0.001*	55(67.1)	62(12.5)	<0.001*
Intraoperative blood loss> 3000 mL	46(29.9)		17(3.0)	<0.001*	38(52.8)	12(16.9)	<0.001*	8(9.8)	5(1.0)	<0.001*
Bleeding within 2 hours after delivery, mL	34.7±89.7		28.5±58.8	0.353	44.4±113.1	19.9±44.6	0.109	25.6±59.7	29.8±60.5	0.607
Bleeding within 2–24 hours after delivery, mL	168.2±370.1		49.9±58.4	<0.001*	220.1±436.4	65.5±114.2	0.007*	118.9±289.9	47.7±45.1	<0.001*
Postpartum hemorrhage	75(48.7)		90(15.7)	<0.001*	19(26.4)	14(19.4)	0.322	56(68.3)	76(15.2)	<0.001*
Transfusion	53(34.6)		92(16.1)	<0.001*	28(39.4)	24(33.3)	0.448	25(30.5)	68(13.6)	<0.001*
Hemorrhagic shock	12(7.8)		11(1.9)	<0.001*	10(13.9)	4(5.6)	0.091	2(2.4)	7(1.4)	0.480
Postpartum anemia	39(23.5)		172(30.1)	0.250	19(26.4)	30(41.7)	0.053	20(24.4)	142(28.4)	0.453
Hysterectomy	4(2.6)		3(0.5)	0.019*	4(5.6)	2(2.8)	0.404	0	1(0.2)	0.685
Neonatal
Infant weight, g				0.916			0.616			0.826
<1500	6(3.9)		23(4.1)		2(2.8)	1(1.4)		4(4.9)	22(4.4)
1500–2500	35(22.9)		145(25.6)		17(21.8)	21(29.6)		18(22.0)	124(25.0)
2500–4000	111(72.5)		396(69.8)		51(71.8)	49(69.0)		60(73.2)	347(70.0)
>4000	1(0.7)		3(0.5)		1(1.3)	0		0	3(0.6)
Intrauterine death	0(0)		4(0.7)	0.298	0(0)	0(0)	-	0	4(0.8)	0.416
Fetal distress	55(35.7)		69(12.1)	<0.001*	26(36.1)	13(18.1)	0.015*	29(35.4)	56(11.2)	<0.001*
Umbilical cord blood pH	7.17±0.78		7.25±0.45	0.212	7.24±0.12	7.26±0.10	0.442	7.12±1.00	7.25±0.48	0.157
APGAR <7at 1 min	23(15.2)		40(7.1)	0.002*	17(24.6)	9(12.9)	0.075	6(7.3)	31(6.3)	0.715
APGAR <7at 5 min	4(2.6)		16(2.8)	0.877	1(1.4)	1(1.4)	0.992	3(3.7)	15(3.0)	0.769

Notes: Data are mean±SD (independent t-test) or n (%) (x² test) or Fisher’s Exact Test.; *P < 0.05. Percentages do not total 100% owing to missing data.

Abbreviations: n, number of observations; SD, standard deviation; PASD, placenta accreta spectrum disorder; PPCS, placenta previa with coverage of a uterine scar.

Figure 2 Box plots of intraoperative blood loss in the PPCS and Non-PPCS groups of women with and without PASD. *Using t-test for differences between Non-PPCS group and PPCS group.