CC-BY-NC-ND 4.0 · AJP Rep 2018; 08(02): e74-e78
DOI: 10.1055/s-0038-1641163
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Complete Placenta Previa: Ultrasound Biometry and Surgical Outcomes

Alison C. Wortman
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Stephanie L. Schaefer
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Donald D. McIntire
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Jeanne S. Sheffield
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
,
Diane M. Twickler
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas
Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
› Author Affiliations
Further Information

Publication History

04 August 2017

23 February 2018

Publication Date:
20 April 2018 (online)

Abstract

Objective To evaluate the relationship between surgical outcomes and ultrasound measurement of placental extension beyond the cervical os in women with placenta previa.

Study Design This is a retrospective cohort study of singleton pregnancies with placenta previa undergoing third-trimester ultrasound and delivering at our institution from 2002 through 2011. For study purposes, an investigator measured placental extension, defined as the placental distance from the internal os across the placenta continuing out to the lowest placental edge. If morbidly adherent placentation was suspected, women were excluded. Receiver operating characteristic (ROC) curves were developed for pertinent surgical outcomes, and multivariate analysis was performed to determine the placental extension with the best predictive discriminatory zone.

Results In total, 157 women had placenta previa, ultrasound, and delivery data: 86 (55%) had a placental extension of <40 mm, and 71 (45%) had a placental extension of ≥40 mm. Women with placental extension of ≥40 mm had increased surgical time, blood loss > 2,000 mL, blood transfusion, and rate of peripartum hysterectomy. After multivariate analysis, only peripartum hysterectomy and surgical time > 90 minutes remained significant, p ≤ 0.05 and p ≤ 0.01, respectively.

Conclusion In women with placenta previa, the placental extension ultrasound measurement of ≥40 mm is a predictor of adverse surgical outcomes.

Note

This study was presented at the Society for Maternal-Fetal Medicine 35th Annual Meeting, Poster Session IV, February 2–6, 2015.