Final outcome of a second trimester low-positioned placenta: A systematic review and meta-analysis
| Autor: | Liesbeth van Leeuwen, Eva Pajkrt, Ben W.J. Mol, Charlotte H.J.R. Jansen, Laura Ruiter, Jacqueline Limpens, Madelon van Wely, C. Emily Kleinrouweler |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Placenta Placenta Previa Ultrasonography Prenatal Pregnancy medicine Humans Cervix reproductive and urinary physiology business.industry Obstetrics Pregnancy Outcome Obstetrics and Gynecology Gestational age medicine.disease Placenta previa Low-Lying Placenta medicine.anatomical_structure Reproductive Medicine Fundus (uterus) Pregnancy Trimester Second Meta-analysis embryonic structures Female business |
| Zdroj: | European Journal of Obstetrics & Gynecology and Reproductive Biology. 240:197-204 |
| ISSN: | 0301-2115 |
| DOI: | 10.1016/j.ejogrb.2019.06.020 |
| Popis: | Low-positioned placentas which are located in the lower uterine segment (LUS), either a low-lying placenta or a placenta previa, are associated with increased obstetric risks. However, most second trimester low-positioned placentas resolve during pregnancy and have a higher position in the third trimester, without posing any risks. We performed a systematic review and meta-analysis to evaluate the proportion of second trimester low-positioned placentas that have a position towards the fundus in the third trimester. Our aim was to find a cut-off value that included all women in whom the placenta will remain low in the third trimester, thus who are at increased risk of obstetric complications. Subsequently, we assessed whether an anterior or posterior placental location influenced this proportion. We searched MEDLINE and EMBASE and clinicaltrials.gov up to April 2019 for studies on the sonographic follow-up of second trimester low-positioned placentas, with a distance between the placenta and the internal os of the cervix of 20 mm or less at a gestational age of above 15 week and a follow up after 28 weeks. Studies were scored on methodological quality using the Newcastle-Ottowa Scale (NOS). A meta-analysis was conducted to summarize the proportion of second trimester low-positioned placentas with a position towards the fundus in the third trimester. We calculated the proportion at different cut-off values of the distance from the placental edge to the internal os of the cervix (0 mm, 10 mm and 20 mm). Also, anteriorly and posteriorly located placentas and women with and without a prior cesarean delivery were compared. We included 11 eligible studies which reported on 3586 women with a low-positioned placenta in the second trimester. Proportions of placentas with a position towards the fundus in the third trimester ranged between 0.63 and 1.0. Pooled proportions were 0.90 (95% CI 0.87-0.93) for IOD |
| Databáze: | OpenAIRE |
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