Original scientific paper
ULTRASOUND ASSESSMENT OF PLACENTA PREVIA »MIGRATION« IN RELATIONSHIP TO MATERNAL DEMOGRAPHIC FACTORS
Mladen Predanić
; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Jamaica Hospital Medical Center, New York, NY
Sriram C Perni
; Department of Obstetrics and Gynecology, St. Elizabeth Hospital Medical Center, Youngstown, Ohio
Rebecca N Baergen
; Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY
Steven T Chasen
; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology Weill Medical College of Cornell University, New York, NY
Abstract
Objective. To assess the association between maternal age, parity, history of prior cesarean delivery and placental location in evaluating the persistence and rate of placental migration in low-lying or complete placenta previas followed by serial ultrasound examination. Study design. This is a retrospective study of 92 cases of low-lying/placenta previa diagnosed at 28 weeks of gestation followed serially by transvaginal ultrasound. The patients were stratified into three groups depending on the placenta to internal cervical os distance: (1) an overlap of 0.0 cm and over the cervical os (complete previa), (2) 0.1 to 2.9 cm (marginal placenta previa), (3) 3.0 cm or above (normal placental location). The ¬prevalence of complete and marginal placenta previas, and the mean rate of placental »migration« (mm/week) were ¬obtained at 28 and 36 weeks of gestation, and compared with maternal age, parity, history of prior cesarean delivery and placental location. Results. At the time of delivery, 51 patients had placenta previa: 22 complete and 29 marginal placenta previas. In contrast, 41 patients had sufficient placental ’migration’ to be categorized into the normal placental location group. The prevalence of complete placenta of 3.3% and 6.5% at 28 weeks, and 3.3% and 5.4% at 36 weeks’ gestation, for patients who had parity more than 1, or history or prior cesarean delivery (CD), respectively, was not statistically significant. The rate of placental migration was significantly associated with maternal age (p=0.002), while did not differ when stratified by parity (p=0.672) or prior history of CD (p=0.805), or placental location (p=0.147). Conclusion. Maternal age significantly modifies the rate of placenta previa migration. A history of prior CD, maternal parity and placental location did not affect the rate of placental migration in our sample of patients with complete or marginal placenta previa diagnosed by ¬ultrasound at 28 weeks’ gestation.
Keywords
placenta previa; ultrasound; migration; delivery; parity
Hrčak ID:
23284
URI
Publication date:
1.3.2007.
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