Abstract
Through this study, we aimed to evaluate the effects of different types of placenta previa (PP) on maternal and neonatal outcomes. This study was conducted in The Third Affiliated Hospital of Guangzhou Medical University and Tongji Hospital between January 2009 and 2019. PP was traditionally classified into four types, namely low-lying placenta, marginal, partial, and complete PP. Previous studies have classified PP into two types, namely low-lying placenta and PP. Based on our clinical experience, we proposed the classification of PP into three types, for the first time, which included low-lying placenta, "marpartial" (marginal and partial) PP, and complete PP. Multivariate logistic regression analysis was performed to determine the effects of different types of PP on maternal and neonatal outcomes. In total, 4490 singleton pregnancies were complicated with PP. In the four-classification method, compared with women with low-lying placenta, women with complete PP had a risk of placenta accrete spectrum disorders, postpartum hemorrhage (PPH), hemorrhagic shock, severe PPH, blood transfusion, hysterectomy, puerperal infection, preterm labor, NICU admission, and low birth weight. There was no difference in maternal and neonatal outcomes between marginal and partial PP, except for increased chances of preterm labor and low birth weight in partial PP. In the two-classification method, PP was the risk factor for most of the adverse maternal and neonatal outcomes, compared with low-lying placenta. Complete PP and low-lying placenta were associated with the highest and lowest risks of adverse pregnancy outcomes, respectively, whereas clinically similar outcomes were observed between marginal and partial PP. The three-classification of PP may be practical from the clinical perspective.
Highlights
The previously reported incidence of placenta previa (PP) was approximately 4.0 per 1000 births[1]
The traditional classification of PP was complete PP, partial PP, marginal PP, and low-lying placenta[8]
We found that PP increases the risk of placenta accrete spectrum (PAS), postpartum hemorrhage (PPH), hemorrhagic shock, severe PPH, blood transfusion, hysterectomy, puerperal infection, preterm labor, admission to neonatal intensive care unit (NICU), and low birth weight (Tables 2 and 3)
Summary
The previously reported incidence of placenta previa (PP) was approximately 4.0 per 1000 births[1]. The incidence is increasing with the increasing rate of cesarean deliveries[2,3]. The fetus may experience preterm delivery, or may have low birth weight or congenital defects[6,7]. PP is defined as the placenta overlying the endocervical os. The traditional classification of PP was complete PP (the placenta covers the internal os completely), partial PP (the placenta covers the internal os partially), marginal PP (the placental edge just reaches the margin of the internal os), and low-lying placenta (the placental edge is within 2 cm of the internal os)[8]. Advances in ultrasonography have enabled its use to evaluate suspected PP[9]. Determining the location of the placenta using ultrasonography during mid-pregnancy is a routine practice[2]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
