Effects of the number of antenatal hemorrhage episodes on complete placenta previa neonatal outcomes.

AIM: Our study aimed to investigate the association between the number of antepartum hemorrhage (ANH) episodes and pregnancy outcome in patients with complete placenta previa (PP).

MATERIALS AND

METHODS

In this study, 260 patients with totalis PP were divided into five groups based on the number of ANH episodes: Group 1 (no bleeding); Group 2 (bleeding once); Group 3 (bleeding twice); Group 4 (bleeding three times), and Group 5 (bleeding more than three times). Demographic characteristics, obstetric histories, clinical outcomes, and neonatal outcomes of the groups were compared.

RESULTS

The study found significant differences in birth weight percentile, percentage birth weight, and pairwise comparisons between groups, with the highest median percentile in Group 2 and the lowest in Group 4 (P = 0.006). The study found that an increase in bleeding episodes led to a significant decrease in the birth week, from 37.5 weeks in Group 2 to 32.3 weeks in Group 5 (P = 0.001). The birth week was significantly different between groups, with significant differences observed in various comparisons. The study found significant differences in birth weight between different groups, with Group 5 having the lowest mean birth weight. Pairwise comparisons showed significant differences in birth weight between different groups, with Group 5 having the lowest mean weight. The study found significant differences in neonatal intensive care unit (NICU) admission rates between groups, with Group 5 having the highest rate (65.0%). The study analyzed gestational age in patients with PP using Kaplan-Meier survival curve analysis. Results showed that patients with no bleeding episodes had the longest gestational age at delivery, while those with one bleeding episode had the longest. The study suggests an increasing number of bleeding episodes correlates with earlier labor.

CONCLUSION

This study is the first to investigate the association between the number of ANH episodes due to complete PP and birth and neonatal outcomes. The findings demonstrate that these outcomes were significantly worse in pregnancies complicated by PP with a higher number of ANH episodes.