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Bora Coskun , Iltac Akkurt, Riza Dur, Mehmet Ozgur Akkurt,

Prediction of maternal near-miss in placenta previa: a retrospective analysis from a tertiary center in Ankara, Turkey. Bora Coskun , Iltac Akkurt, Riza Dur, Mehmet Ozgur Akkurt, Seval Yilmaz Ergani, Bugra Coskun. Aim.

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Bora Coskun , Iltac Akkurt, Riza Dur, Mehmet Ozgur Akkurt,

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  1. Prediction of maternal near-miss in placenta previa: a retrospective analysis from a tertiary center in Ankara, Turkey. Bora Coskun, Iltac Akkurt, Riza Dur, Mehmet Ozgur Akkurt, Seval Yilmaz Ergani, BugraCoskun

  2. Aim • Placenta previa (PP) posesbothmaternalandfetalrisksanditsincidence has beenincreasing in parallelwiththe cesarean delivery (CD) rates. • Inthepresentstudyweaimedtodeterminethe risk factorsforcomplicated CD in placenta previa.

  3. Methods • This retrospective study was performed at EtlikZubeydeHanim Maternity and Women’s Health Teaching and Research Hospital during 6-year study period. • Women with total and partial PP were included. • Complicated CD was identified according to modified World Health Organization (WHO) maternal near-miss criteria.

  4. WHO near-miss criteria • Coagulation and hematological dysfunction defined as transfusion of 4 and more units of red blood cells, a rapid drop in hemoglobin levels (>4g/dl) and acute thrombocytopenia <75.000/ml • Reoperation, hysterectomy, balloon placement and uterine artery and/or hypogastric artery ligation for hemorrhage, • Prolonged postoperative hospitalization (>4 days), • Intra-and/or post-operative complications such as bladder, ureter, bowel injury, • Renal dysfunction (creatinine >3.5 mg/dl), • Admission to intensive care unit.

  5. Comparison of variables between complicated and non-complicated groups

  6. Logistic regression analysis for identification of independent risk factors for maternal near-miss in placenta previa

  7. Results • 37and 219 women formed complicated and non-complicated group, respectively. • Logistic regression analysis demonstrated that following features were associated with complicated CD in PP; 1) coexistent abruption (aOR 13.2, 95% CI 5.8-75.3), 2) adherent placenta (aOR 11.92, 95% CI 3.24-43.82), 3) 3 and more hospitalization for vaginal bleeding (aOR8.88, 95% CI 3.32-26.69), 4) cervical length (CL) measurement < 10. Percentile (aOR 5.5, 95% CI 2.1-15.4).

  8. Conclusion • Short cervical length, recurrent vaginal bleeding, morbidly adherent placenta, and concurrent placental abruption are independent predictors for subsequent severe morbidity in women with placenta previa. • Early identification of these factors during follow-up may improve outcome.

  9. Teşekkürler…

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