Management of placenta previa cases and determination of hospitalization criteria

Despite the experiences and dizzying technological development, peripartum hemorrhage it is located in the first row among the causes of maternal morbidity and mortality. One of the difficult patient groups to manage for modern obstetrics practice is placenta previa cases. When the literature is evaluated extensively, no clear information can be seen especially in terms of hospitalization time. Placenta previa cases who were admitted to Ege University Faculty of Medicine Department of Obstetrics and Gynecology between 2016-2019 were included in the prospective clinical study. The number of participants was 98. The age of the cases, their pregnancies and their births were recorded. The amount and time of bleeding which are very common in placenta previa cases and significant for clinical results were recorded. The bleeding follow-up continued until the end of pregnancy. At 32nd gestational week, the cases were evaluated by vaginal ultrasonography as gray scale and doppler parameters. In our study, it was revealed that bleeding before 28 weeks and / or having two or more bleeding attacks is related to the need for emergency cesarean section and this relationship is statistically significant (p<0,05). The relationship of the cervical length less than 30 mm was shown to be associated with emergency caesarean section and this relationship was statistically significant (p<0,05). The number of pregnancies and previous cesarean section were statistically significantly correlated with placental invasion pathologies (p<0,05). In addition, as an important information obtained from the study, no relationship was found between the need for emergency cesarean section and invasion pathologies in placenta previa cases (p=0,241). The surgical team equipped for the management of patients with placenta previa, an experienced anesthesia group and an active blood center that can provide high levels of support are essential. As a result, it is important to determine which patient has a high risk for emergency surgical intervention to personalize management and to prevent hospitalization for months.