The choice of the delivery time in patients with placenta previa and accreta, taking into account the prognosis for the fetus

Makukhina T.B.

Kuban State Medical University Russian Federation;
Regional Clinical Hospital No 2 of the Krasnodar Territory

Penzhoyan G.A.

Kuban State Medical University Russian Federation

Model G.Yu.

Kuban State Medical University Russian Federation;
Regional Clinical Hospital No 2 of the Krasnodar Territory

Shabunina V.I.

Regional Clinical Hospital No 2 of the Krasnodar Territory

Amirkhanyan A.M.

Kuban State Medical University Russian Federation;
Regional Clinical Hospital No 2 of the Krasnodar Territory

Doncova M.V.

Kuban State University

The choice of the delivery time in patients with placenta previa and accreta, taking into account the prognosis for the fetus

Authors:

Makukhina T.B., Penzhoyan G.A., Model G.Yu., Shabunina V.I., Amirkhanyan A.M., Doncova M.V.

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Journal: Russian Bulletin of Obstetrician-Gynecologist. 2022;22(4): 73‑80

DOI: 10.17116/rosakush20222204173

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To cite this article:

Makukhina TB, Penzhoyan GA, Model GYu, Shabunina VI, Amirkhanyan AM, Doncova MV. The choice of the delivery time in patients with placenta previa and accreta, taking into account the prognosis for the fetus. Russian Bulletin of Obstetrician-Gynecologist. 2022;22(4):73‑80. (In Russ.)
https://doi.org/10.17116/rosakush20222204173

Подписка 2025-2 (Russian Bulletin of Obstetrician-Gynecologist)

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THE PURPOSE OF THE STUDY

To compare neonatal outcomes of pregnancies complicated by placenta praevia and placenta accreta depending on the gestational age to optimize the delivery time.

MATERIAL AND METHODS

A retrospective cohort study of the deliveries at 2014-2020 years with placenta praevia and clinically verified placenta accreta in the Perinatal Center of the Regional Clinical Hospital №2 in Krasnodar. Exclusion criteria: chromosomal abnormalities, congenital malformations, hemolytic disease of the fetus, multiple pregnancies, antenatal demise, incomplete data of neonatal outcome. Adjusted odds ratio (aOR) of the effect of gestational age (GA) at emergency delivery on neonatal outcomes were calculated.

RESULTS

The study included 258 patients; emergency caesarean section (eCS) — in 63 (24.4%). The frequency of eCS did not increase with increasing gestational age (<34^0— weeks=24; 34—35^0—⁶ weeks=16; 36^0—⁶ weeks=8; >37⁰ weeks=15). In cases of eCS before 36 weeks of GA, there was an increase in the incidence of a low Apgar score for 5 min, asphyxia at birth, the need for oxygen support, stay in the NICU, the length of hospital stay and transfer to the second stage of nursing compared with eCS at >37⁰ weeks (aOR=71.45; 11.55; 24.53; 24.53; 47.92; 16.64; p=0.009; 0.017; 0.024; 0.024; 0.035; 0.017 respectively). There was an additional increased risk of congenital pneumonia with eCS before 34⁰ weeks (aOR=4.63; p=0.047). Emergency CS at 36^0—⁶ weeks compared to> 37⁰ weeks had no additional risks apart from asphyxia and neonatal jaundice (aOR=7.14; 21.59; p=0.033; 0.035).

CONCLUSION

Prolongation of pregnancy in patients with placenta praevia and placenta accreta up to term does not increase the risk of eCS and significantly improves neonatal outcomes.

Keywords:

placenta praevia

placenta accreta spectrum

neonatal outcomes

Authors:

Makukhina T.B.

Kuban State Medical University Russian Federation;
Regional Clinical Hospital No 2 of the Krasnodar Territory

Penzhoyan G.A.

Kuban State Medical University Russian Federation

Model G.Yu.

Kuban State Medical University Russian Federation;
Regional Clinical Hospital No 2 of the Krasnodar Territory

Shabunina V.I.

Regional Clinical Hospital No 2 of the Krasnodar Territory

Amirkhanyan A.M.

Kuban State Medical University Russian Federation;
Regional Clinical Hospital No 2 of the Krasnodar Territory

Doncova M.V.

Kuban State University

Received:

02.03.2022

Accepted:

18.03.2022

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