Validation of management of planned cesarean section at 38 weeks of gestation for women with asymptomatic placenta previa

Abstract

Objective: To verify the adequacy of a management method at perinatal centers where there is a planned cesarean section at 38 weeks of gestation for women with asymptomatic placenta previa at 36 weeks of gestation. Method: This retrospective observational study included 94 women with singleton placenta previa, excluding placental adhesion disorder. Mothers without symptoms such as antenatal bleeding and regular uterine contraction were managed with bed rest alone. In these mothers, mothers diagnosed with asymptomatic previa at 36 weeks of gestation defined as a low risk group were scheduled for cesarean section after 38 weeks of gestation. Adverse events of mothers and neonates were examined in the low risk group.

Results: In this study, 27 of the 94 women were extracted as the low risk group. Of these 27, 25（93％） underwent the planned cesarean section after 38 weeks of gestation. Among the 27, compared with other reports from Japan, there was a low rate（7％）of emergency cesarean sections and little hemorrhaging at delivery （mean: 1447 g）without blood transfusion. No other hemostasis treatment including transcatheter arterial embolization and hysterectomy was required. No neonatal asphyxia was observed. Two neonates（7％）were admitted to a neonatal intensive care unit.

Conclusion: This study found women with no symptomatic placenta previa at 36 weeks of gestation could be managed safely with a planned cesarean at 38 weeks of gestation without deterioration of short-term prognosis of neonates.