engleski

Maternal and neonatal outcome in pregnancies complicated with placenta previa versus placental abruption

BACKGROUND To analyze maternal and neonatal outcome among women with diagnosis of placenta previa and placental abruption. METHODS All singleton deliveries at our institution between 1996-2000 complicated with placenta previa (PP) were compared with those complicated with placental abruption (PA). A total of 126 cases were analyzed. The PP group comprised 55 and PA group 71 cases. Statistical analysis was preformed using SPSS 10.0 program with &#967; 2 test and Fischer-Exact test.RESULTS Pregnancies complicated with PP had significantly higher rate of 2nd and 3rd trimester bleeding compared with PA group (90.9% vs. 69.0% ; p<0.01). The operative delivery rate was also higher among women with PP (90.9% vs. 60.6% ; p<0.01). The rate of preterm deliveries did not differ significantly between PP and PA group (62.3% vs. 69.0% ; p>0.05). Significantly higher rate of low Apgar scores in the 5th minute (&#8804; 7) was found in PA group (48.1% vs. 20.0% ; p<0.01). The rate of mild acidosis (pH=7, 0-7.19) was also higher in PA group in comparison with PP group (31.3% vs. 20.5% ; p<0.01). Extreme acidosis (pH<7.0) was found in 37.5% of PA group and in 12.8% of PP group (p<0.05). Pregnancy outcome was more favorable in PP group were no fetal nor neonatal death was observed. On the contrary, in 25.4% of pregnancies complicated with PA fetus died in utero and in 7.0% of cases neonatal (0-6 days) death was observed. The observed neonatal complications were in PP vs. PA group as follows: RDS (7.3% vs. 11.3%), anemia (9.1% vs. 5.6%), perinatal infection (12.7% vs. 18.3%), perinatal cerebral hemorrhage (0% vs. 5.6%) and congenital malformations (1.4% vs. 5.5%). The differences were not significant. No maternal death was observed in both groups. The most serious maternal complication after delivery was bleeding. The rate of bleeding measured with need for transfusion was in PP group 21.8% and in PA group 23.9%. Emergency postoperative hysterectomy was performed in 2 cases of PP.CONCLUSION Both PP and PA are serious obstetric emergencies, which need careful evaluation with timed delivery in order to reduce associated maternal and neonatal complications.

placenta previa; placental abruption

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