C M Lam1, S F Wong. 1. Department of Obstetrics and Gynaecology, Princess Margaret Hospital, 2-10 Princess Margaret Hospital Road, Hong Kong.
Abstract
OBJECTIVE: To identify risk factors for preterm delivery in women with placenta praevia and antepartum haemorrhage. DESIGN: Retrospective study. SETTING: Regional obstetric unit, Hong Kong. SUBJECTS AND METHODS: Women delivered at Princess Margaret Hospital between 1 January 1990 and 31 December 1997. Possible risk factors for preterm delivery among women with placenta praevia and antepartum haemorrhage including onset, pattern, and severity of vaginal bleeding; presence of uterine contractions on admission; and type of placenta were assessed. RESULTS: Three risk factors for preterm delivery were identified from univariate analysis. These included second trimester vaginal bleeding (odds ratio=4.19; 95% confidence interval, 1.29-13.66), the presence of uterine contractions on admission (odds ratio=4.00; 95% confidence interval, 1.57-10.19), and a haemoglobin decrease of more than 20 g/L (odds ratio=3.00; 95% confidence interval, 1.00-9.04). Using the logistic regression model, second trimester vaginal bleeding and the presence of uterine contractions were found to be independent risk factors for delivery before 36 weeks. CONCLUSION: Preterm delivery is increased in women with placenta praevia and antepartum haemorrhage who have second trimester vaginal bleeding or the presence of uterine contractions. This high-risk group may benefit from close in-patient monitoring and more aggressive management.
OBJECTIVE: To identify risk factors for preterm delivery in women with placenta praevia and antepartum haemorrhage. DESIGN: Retrospective study. SETTING: Regional obstetric unit, Hong Kong. SUBJECTS AND METHODS: Women delivered at Princess Margaret Hospital between 1 January 1990 and 31 December 1997. Possible risk factors for preterm delivery among women with placenta praevia and antepartum haemorrhage including onset, pattern, and severity of vaginal bleeding; presence of uterine contractions on admission; and type of placenta were assessed. RESULTS: Three risk factors for preterm delivery were identified from univariate analysis. These included second trimester vaginal bleeding (odds ratio=4.19; 95% confidence interval, 1.29-13.66), the presence of uterine contractions on admission (odds ratio=4.00; 95% confidence interval, 1.57-10.19), and a haemoglobin decrease of more than 20 g/L (odds ratio=3.00; 95% confidence interval, 1.00-9.04). Using the logistic regression model, second trimester vaginal bleeding and the presence of uterine contractions were found to be independent risk factors for delivery before 36 weeks. CONCLUSION: Preterm delivery is increased in women with placenta praevia and antepartum haemorrhage who have second trimester vaginal bleeding or the presence of uterine contractions. This high-risk group may benefit from close in-patient monitoring and more aggressive management.
Authors: Yamini V Pusdekar; Archana B Patel; Kunal G Kurhe; Savita R Bhargav; Vanessa Thorsten; Ana Garces; Robert L Goldenberg; Shivaprasad S Goudar; Sarah Saleem; Fabian Esamai; Elwyn Chomba; Melissa Bauserman; Carl L Bose; Edward A Liechty; Nancy F Krebs; Richard J Derman; Waldemar A Carlo; Marion Koso-Thomas; Tracy L Nolen; Elizabeth M McClure; Patricia L Hibberd Journal: Reprod Health Date: 2020-12-17 Impact factor: 3.223