Placenta previa with early opening of the uterine isthmus is associated with high risk of bleeding during pregnancy, and massive haemorrhage during caesarean delivery
| Autor: | Masamitsu Nakamura, Junichi Hasegawa, Hiroko Takita, Minako Goto, Akihiko Sekizawa, Tatsuya Arakaki, Tomohiro Oba |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Placenta Previa Uterus Ultrasonography Prenatal 03 medical and health sciences 0302 clinical medicine Pregnancy Humans Medicine Caesarean section Prospective Studies Prospective cohort study Gynecology 030219 obstetrics & reproductive medicine Cesarean Section business.industry Obstetrics Uterine Hemorrhage Obstetrics and Gynecology medicine.disease Placenta previa Uterine isthmus medicine.anatomical_structure Reproductive Medicine 030220 oncology & carcinogenesis embryonic structures Gestation Female business |
| Zdroj: | European Journal of Obstetrics & Gynecology and Reproductive Biology. 201:7-11 |
| ISSN: | 0301-2115 |
| Popis: | To demonstrate the relationship between the timing of opening of the uterine isthmus and bleeding during pregnancy and caesarean section in patients with placenta previa.A prospective observational study was conducted at a single perinatal centre. All patients with placenta previa, diagnosed between 20 and 22 weeks of gestation, who were followed up at the study hospital and underwent caesarean section were enrolled. The condition of the uterine isthmus was examined every 2 weeks. The timing (in gestational weeks) of complete opening of the uterine isthmus was determined. Patients were divided into two groups: patients in whom the uterine isthmus opened before 25 weeks of gestation (EO-previa), and patients in whom the uterine isthmus opened after 25 weeks of gestation (LO-previa). The frequency of bleeding during pregnancy and the amount of intra-operative bleeding were compared between the two groups.Forty-four cases of EO-previa and 55 cases of LO-previa were analysed. Complete placenta previa at delivery was observed more frequently in the EO-previa group than in the LO-previa group (88.6% vs 47.3%, p0.001). An emergency caesarean section due to active bleeding was performed more frequently in the EO-previa group (48%) than in the LO-previa group (25%) (p=0.021). The frequency of massive haemorrage (2500ml) during caesarean section was higher in the EO-previa group than in the LO-previa group (25% vs 9%, p=0.033).Placenta previa was associated with a high risk of bleeding leading to emergency caesarean section during pregnancy, and massive haemorrhage during caesarean section in patients in whom the uterine isthmus opened before 25 weeks of gestation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect