Assessment of Placental Thickness in Cases with Placenta Previa as Marker for Intra and Postpartum Bleeding

Abstract

Background: Evaluating the relationship between placental thickness and placenta accreta spectrum (PAS) disorder in placenta previa  was highlighted as a primary area of interest because the prediction of abnormally invasive placentation in patients with placenta previa  represents significant conflict and is frequently linked to intraoperative blood loss and blood transfusion.

Objective: This study aimed to assess the clinical value of placental thickness as a marker for intra and postpartum bleeding in cases of  placenta previa. Thus, to serve as a guideline for enhancing the clinical outcomes of expectant mothers and their babies while lowering  the frequency of unfavourable pregnancy-related occurrences.

Patients and methods: This prospective study was conducted at Tertiary  Care Hospital, Ain Shams University Hospitals through the period from September 2022 to March 2023. The study included seventy-five  pregnant women with placenta previa. 75 women were enrolled in the trial after 100 patients had their eligibility evaluated. Out of all eligible patients, 10 patients declined to take part in the trial, and 15 patients were excluded from the study due to inclusion  requirements. In the end, the investigation relied on information from 75 placenta previa pregnant women.

Results: As regards the  hemoglobin changes and blood loss, our study results revealed that pre-operative hemoglobin level (gm/dL) and post-operative  hemoglobin level (gm/dL) were 11.4 ± 0.9 and 9.8 ± 1.1 respectively with postoperative hemoglobin drop (gm/dL) of 1.7 ± 0.41 and the  blood loss (ml) was 867.3 ± 441.9. The Need to blood transfusion was in 54.7% of the studied cases. The number of transfused units of  packed RBCs was one unit.

Conclusion: It is feasible to measure placental thickness in a straightforward manner. Consequently, it can be  utilised as a screening test for placenta previa patients, especially those who had a Caesarean section (CS) in the past and had a very poor  diagnostic performance in terms of anticipating blood loss and the need for blood transfusions.