Precise mid-trimester placenta localisation: does it predict adverse outcomes?

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dc.contributor.authorRobinson, A.
dc.contributor.authorMuller, P.
dc.contributor.authorAllan, R.
dc.contributor.authorRoss, R.
dc.contributor.authorBaghurst, P.
dc.contributor.authorKeirse, M.
dc.date.issued2012
dc.description.abstractBACKGROUND: A low-lying placenta detected at the mid-pregnancy ultrasound is commonly reported to warn against potential morbidity associated with placenta praevia. There is no information on what distance away from the internal cervical os is safe. AIMS: We examined whether a low-lying placenta not overlapping the cervical os in the second trimester increases the risk of obstetric complications and whether there is a cut-off point at which that increase occurs. METHODS: Adverse perinatal outcomes were examined prospectively in a cohort of women with a placenta 0–30 mm from the internal cervical os (low-lying) at the routine mid-trimester ultrasound and compared to those with a placenta further away. Two composite outcomes of major and minor adverse events were predefined as primary outcome measures, requiring a sample size of 480 women with a low-lying placenta. Chi-square and Fisher’s exact tests were used for statistical analysis. RESULTS: In 1662 pregnancies (low-lying: n = 484; normal: n = 1178), there was no increase in composite adverse outcomes with a low-lying placenta and no cut-off distance within 30 mm from the cervical os at which risks increased. Postpartum haemorrhage >1000 mL was more frequent with a low-lying placenta (7.6% vs 4.7%, P < 0.05). CONCLUSIONS: Women with a low-lying placenta, not overlapping the cervical os, in mid-pregnancy are at no higher risk of adverse outcomes than those with a normally located placenta, except postpartum haemorrhage. This suggests that the high-risk label can be removed from pregnancies with a low-lying placenta not overlapping the cervical os in midpregnancy, reducing anxiety and resource utilisation.
dc.description.statementofresponsibilityAlice J. Robinson, Peter R. Muller, Richard Allan, Richard Ross, Peter A. Baghurst and Marc J.N.C. Keirse
dc.identifier.citationAustralian and New Zealand Journal of Obstetrics and Gynaecology, 2012; 52(2):156-160
dc.identifier.doi10.1111/j.1479-828X.2012.01416.x
dc.identifier.issn0004-8666
dc.identifier.issn1479-828X
dc.identifier.urihttp://hdl.handle.net/2440/73544
dc.language.isoen
dc.publisherBlackwell Publishing Asia
dc.rights© 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists
dc.source.urihttps://doi.org/10.1111/j.1479-828x.2012.01416.x
dc.subjectmid-trimester
dc.subjectplacenta
dc.subjectplacenta praevia
dc.subjectpregnancy outcome
dc.subjectultrasound
dc.subjectvasa praevia
dc.titlePrecise mid-trimester placenta localisation: does it predict adverse outcomes?
dc.typeJournal article
pubs.publication-statusPublished

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