Abstract

Objective: The majority of previa-related bleeding is due to an adhesive placenta. The risk factors are already well known. Although antenatal bleeding in women with placenta previa is another problem, the risk factors have not been identified. Our aim is to investigate the risk factors for antenatal bleeding in women with placenta previa.

Methods: This was a retrospective study of postpartum women who received an ultrasound diagnosis of placenta previa. Included women were divided into two groups based on whether they had antenatal bleeding or not. Sonographic images were reviewed. Parameters assessed included loss of the retroplacental clear zone, irregularity of uterine-bladder interface, number of lacunar spaces, vasa previa and increased vascularity around placenta. We also assessed the type of placenta previa, placenta location, cervical length at third trimester and obstetric histories. Statistical analyses were performed using a t-test, X2 test and logistic regression test.

Results: Of 109 patients included, 55 (50.5%) experienced antenatal bleeding. There was no significant difference in maternal age between the two groups (P=0.903). Obstetric histories, cervical length at third trimester and sonographic findings were not significantly different.

Conclusion: Prediction of antenatal bleeding in placenta previa using obstetrical history and sonographic finding is difficult.

Keywords: Placenta previa; Antenatal bleeding; Ultrasound