Objective: This study aimed to compare emergency and planned cesarean section cases in pregnancies complicated with placenta previa (PP) and subgroups with and without placenta accreta spectrum (PAS) in terms of obstetric, neonatal, and surgical outcomes.
Materials And Methods: This retrospective cohort study included 128 patients diagnosed with PP who underwent cesarean section. Obstetric, neonatal, and surgical outcomes of all cases with PP and subgroups with and without PAS were compared according to whether they were emergency or planned cesarean section.
Results: Of the 128 women with PP, 60 planned and 68 underwent emergency cesarean section. In all patients with PP and in the PAS and non-PAS subgroups, the neonatal outcomes of patients who underwent emergency cesarean section were more negative than those of patients who underwent planned cesarean section. It was observed that more hysterectomy were performed in the emergency group than in the elective group in all patients with PP and PAS patients (p=0.027 and p=0.012 respectively). It was observed that patients with PP and non-PAS were hospitalized after cesarean section for a longer period of time in the emergency group than in the planned group (p=0.044 and p=0.002 respectively).
Conclusion: Planned cesarean section leads to better obstetric, neonatal, and surgical outcomes compared with emergency cesarean section in pregnancies complicated by PP, especially in those with PAS. Our findings suggest that planned delivery strategies should be considered for patients with PP. Decisions regarding the timing of delivery should balance maternal risks and benefits with fetal and fetal risks and benefits.
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http://dx.doi.org/10.4274/tjod.galenos.2024.58291 | DOI Listing |
BMC Pregnancy Childbirth
December 2024
Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, 5612 AZ, North Brabant, The Netherlands.
This study aimed to predict preterm birth in nulliparous women using machine learning and easily accessible variables from prenatal visits. Elastic net regularized logistic regression models were developed and evaluated using 5-fold cross-validation on data from 8,830 women in the Nulliparous Pregnancy Outcomes Study: New Mothers-to-Be (nuMoM2b) dataset at three prenatal visits: - , - , and - weeks of gestational age (GA). The models' performance, assessed using Area Under the Curve (AUC), sensitivity, specificity, and accuracy, consistently improved with the incorporation of data from later prenatal visits.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
December 2024
Department of Obstetrics and Gynecology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
Background: Placenta accreta spectrum (PAS) is one of the most dangerous pregnancy-related conditions. This study aims to conduct a systematic review of current research on the ultrasound scoring systems used in PAS patients with a comprehensive summarization of researches and comparison of prenatal ultrasound scoring in evaluating postpartum outcomes.
Methods: This systematic review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Am J Perinatol
December 2024
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.
Objective: This study aimed to compare maternal characteristics and pregnancy outcomes between term patients evaluated for decreased fetal movement (DFM) who were delivered versus expectantly managed.
Study Design: Retrospective cohort study of term patients delivering within a large hospital system from 2015 to 2023 who were evaluated for DFM. Patients were classified into three groups based on the time between evaluation for DFM and delivery admission: (1) <24 hours, (2) 24-48 hours, (3) >48 hours.
Psychoneuroendocrinology
December 2024
R&D department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway; Department of Psychiatry, University of Helsinki, Helsinki, Finland; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Objective: To investigate the association prenatal maternal depression and anxiety may have on the levels of neonatal hair steroids (i.e. cortisol, cortisone, and the cortisol/cortisone ratio) at birth.
View Article and Find Full Text PDFHealth Technol Assess
December 2024
Usher Institute, University of Edinburgh, Edinburgh, UK.
Background: Around one in three pregnant women undergoes induction of labour in the United Kingdom, usually preceded by in-hospital cervical ripening to soften and open the cervix.
Objectives: This study set out to determine whether cervical ripening at home is within an acceptable safety margin of cervical ripening in hospital, is effective, acceptable and cost-effective from both National Health Service and service user perspectives.
Design: The CHOICE study comprised a prospective multicentre observational cohort study using routinely collected data (CHOICE cohort), a process evaluation comprising a survey and nested case studies (qCHOICE) and a cost-effectiveness analysis.
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