Plasenta previalı gebelerde acil müdahalenin risk faktörleri ve sonuçları: gözlemsel bir çalışma

Abstract

Aim: To investigate the risk factors and outcomes of emergency intervention in pregnant women with placenta previa (PP). Material and method: This retrospective study was conducted between June 2015 and January 2021. Pregnant women with PP were divided into emergency and planned intervention groups according to surgical planning. The groups were compared in terms of demographic characteristics, presence of antepartum hemorrhage (APH), operation characteristics, and maternal and neonatal outcomes. Results: A total of 434 patients with PP were analyzed. The frequency of PP was 0.52%. The emergency intervention was performed in 168 (38.7%) pregnant women, whereas planned intervention was performed in 266 (61.3%). APH was present in 208 (47.9%) patients; the presence of APH was associated with increased risk of emergency intervention by 3.026 [95% confidence interval (CI), 1.990–4.603; p = 0.000]-fold. The weight gained during pregnancy was associated with reduced risk of emergency intervention by 0.932 (95% CI, 0.887–0.978; p = 0.004)-fold. In the emergency intervention group, more additional surgical procedures and massive transfusion were performed during the operation (p = 0.000 and p = 0.000) Emergency intervention resulted in an increase in adverse maternal and fetal outcomes by 3.064 (95% CI, 1.571–5.975) and 7.5 (95% CI, 4.841–11.620)-fold, respectively. Conclusion: The frequency of an emergency intervention is high in those with PP and is associated with increased adverse maternal and neonatal outcomes.The most effective factor in the prediction of emergency intervention is APH.