Gynäkologie und Geburtshilfe
Offener Zugang

Abstrakt

Management and Time of Delivery in Asymptomatic Complete Placenta Previa: A Case Report and Review of Literature

Genovese F, Marilli I, Carbonaro A, Leanza V, Vizzini S, Leanza G and Pafumi C

The Authors present a case of a 40-year-old primigravida with complete placenta previa, stable and asymptomatic all throughout pregnancy, which was referred, at 34 weeks of gestation, to the high-risk ob clinic of their hospital for follow-up and delivery-plan. Placenta previa is a condition derived from an abnormal implantation of the embryo in the lower uterine segment. Risk factors for the development of placenta previa include: prior cesarean delivery, pregnancy termination, intrauterine surgery, smoking, multi-fetal gestation, increasing parity and maternal age and the rising rates of cesarean section. Usually complete placenta previa becomes symptomatic in the third trimester of pregnancy and it is associated with adverse maternal and neonatal outcomes, such as: antenatal and intra-partum hemorrhage, maternal blood transfusion and emergency hysterectomy, intra-uterine growth restriction and preterm birth. There is no doubt that patients with either partial or complete placenta previa should be delivered by cesarean section; it is not clear, however, at what gestational age the cesarean section should be scheduled in a patient with a stable and asymptomatic total placenta previa. The Authors based the management of the reported case on the review of the last 20-year International Literature, according to which, in the presence of this type of previa, an Early Term Birth (ETB) at 37 weeks and 0 days is associated with a better maternal and neonatal prognosis if compared to both a Late Preterm Birth (LPTB) at 34-36 weeks or a Term Birth (TB) at 38-39 weeks.