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Transecting versus avoiding incision of the anterior placenta previa during cesarean delivery
Author(s) -
Verspyck Eric,
Douysset Xavier,
Roman Horace,
Marret Stephane,
Marpeau Loïc
Publication year - 2015
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2014.07.020
Subject(s) - medicine , placenta previa , cesarean delivery , obstetrics , placenta , pregnancy , fetus , genetics , biology
Objective To compare maternal outcomes after transection and after avoiding incision of the anterior placenta previa during cesarean delivery. Methods In a retrospective study, records were reviewed for women who had anterior placenta previa and delivered by cesarean after 24 weeks of pregnancy at a tertiary center in Rouen, France. During period A (January 2000 to December 2006), the protocol was to systematically transect the placenta when it was unavoidable. During period B (January 2007 to December 2010), the technique was to avoid incision by circumventing the placenta and passing a hand around its margin. Logistic regression was used to identify independent risk factors associated with maternal transfusion of packed red blood cells. Results Eighty‐four women were included (period A: n = 43; period B: n = 41). During period B, there was a reduction in frequency of intraoperative hemorrhage (> 1000 mL) ( P = 0.02), intraoperative hemoglobin loss ( P = 0.005), and frequency of blood transfusion ( P = 0.02) as compared with period A. In multivariable analysis, period B was associated with a reduced risk of maternal transfusion (odds ratio 0.27; 95% confidence interval 0.09–0.82; P = 0.02). Conclusion Avoiding incision of the anterior placenta previa was found to reduce frequency of maternal blood transfusion during or after cesarean delivery.