Yamamoto Hiroto, Yamawaki Kaoru, Haino Kazufumi, Yoshihara Kosuke, Nishijima Koji
Department of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata, JPN.
Cureus. 2024 Nov 30;16(11):e74858. doi: 10.7759/cureus.74858. eCollection 2024 Nov.
Objective This study aimed to investigate whether the amount of blood loss during delivery in patients with low-lying placenta is affected by the planned mode of delivery, internal os distance, and warning bleeding. Materials and methods We conducted a single-center retrospective study encompassing women with singleton pregnancies diagnosed with low-lying placenta between January 2012 and December 2021. Data for maternal demographic details and pregnancy outcomes were extracted from the institution's records. We analyzed blood loss during delivery according to the planned delivery mode, internal os distance (≥10 mm or within 10 mm), and the occurrence of warning bleeding. We also assessed the frequency of abnormal hemorrhage at delivery. Statistical analyses included the Mann-Whitney U test and Fisher's exact probability test, with significance set at p<0.05. Results This study included 27 pregnant women. The planned delivery mode and internal os distance showed no statistically significant impact on the amount of blood loss or frequency of abnormal hemorrhage at delivery. However, the occurrence of warning bleeding had a significant effect on both factors. Conclusion In patients diagnosed with a low-lying placenta with warning bleeding, cautious delivery management is recommended owing to the possible increased risk of abnormal hemorrhage at delivery.
目的 本研究旨在探讨前置胎盘患者分娩时的失血量是否受计划分娩方式、宫颈内口距离及先兆出血的影响。材料与方法 我们进行了一项单中心回顾性研究，纳入了2012年1月至2021年12月期间诊断为前置胎盘的单胎妊娠妇女。从机构记录中提取产妇人口统计学细节和妊娠结局的数据。我们根据计划分娩方式、宫颈内口距离（≥10 mm或在10 mm以内）以及先兆出血的发生情况分析分娩时的失血量。我们还评估了分娩时异常出血的频率。统计分析包括曼-惠特尼U检验和费舍尔精确概率检验，显著性设定为p<0.05。结果 本研究纳入了27名孕妇。计划分娩方式和宫颈内口距离对分娩时的失血量或异常出血频率没有统计学上的显著影响。然而，先兆出血的发生对这两个因素均有显著影响。结论 对于诊断为前置胎盘且有先兆出血的患者，由于分娩时异常出血风险可能增加，建议谨慎进行分娩管理。
