Page 80 - JCTR-11-3

Journal of Clinical and
Translational Research Outcomes of placenta previa with APH

Table 1. Demographic characteristics and ultrasound features of the study participants

Variables APH groups (n=33) Non‑APH group (n=23) p‑value OR (95% CI)
Maternal age a 30.6±2.7 28.4±4.1 0.03 1.22 (1.45 – 1.03)
Gestational age at delivery b 35.5±2.3 37.5±1.0 <0.0001 0.35 (0.65 – 0.19)
Parity (number of live births) b 2.3±1.4 1.61±1.3 0.06 1.51 (2.29 – 1.00)
Gravidity (total number of pregnancies) b 3.6±2.0 2.8±2.2 0.15 1.29 (1.77 – 0.93)
Number of artificial abortions b 0.52±0.71 0.48±0.1 0.34 1.06 (2.03 – 0.55)
Delivery method c (n=22) <0.0001
C-section 4 (12.1%) 9 (40.9%)
Vaginal 6 (18.2%) 12 (54.5%) 1.13 (5.21 – 0.24)
Emergency C-section 23 (69.7%) 1 (4.5%) 51.75 (528.10 – 5.07)
Estimated intraoperative blood loss (mL) b 487.2±213.6 (n=32) 253.5±142.3 (n=20) <0.0001 1.01 (1.01 – 1.00)
Intraoperative blood transfusion (mL) b 348.5±318.3 23.8±109.1 (n=21) <0.0001 1.01 (1.01 – 1.00)
Previous cesarean delivery b 1.1±1.1 1.0±1.3 (n=21) 0.33 1.17 (1.88 – 0.73)
Type of PP c 0.03
Marginal PP 7 (21.2%) 11 (47.8%)
Partial PP 16 (48.5%) 10 (43.5%) 2.51 (8.64 – 0.73)
Complete PP 9 (27.3%) 1 (4.3%) 14.14 (137.30 – 1.46)
Low-lying placenta 1 (3.0%) 1 (4.3%) -
Placental location c (n=32) 0.07
Anterior 16 (50.0%) 7 (30.4%)
Posterior 11 (34.4%) 15 (65.2%) 0.46 (4.67 – 0.05)
Lateral 5 (15.6%) 1 (4.3%) 0.15 (1.44 – 0.02)
Birth weight (g) b 2570±531.8 (n=30) 2945.5±444.8 (n=22) 0.002 0.998 (1.00 – 0.997)
Hemoglobin before delivery b 11.4±1.1 (n=32) 11.6±0.9 0.58 0.83 (1.45 – 0.47)
Hemoglobin after delivery a 10.2±1.1 (n=32) 10.9±0.9 0.01 0.48 (0.88 – 0.26)
Education level c 0.21
High school or less 8 (24.2%) 7 (30.4%)
College 6 (18.2%) 8 (34.8%) 0.66 (2.84 – 0.15)
Graduate 19 (57.6%) 8 (34.8%) 2.08 (7.69 – 0.56)
b
c
a
Notes: Independent t-test, Mann–Whitney U test, Pearson Chi-square test; Values are expressed as either mean±SD or count (percentage).
Abbreviations: APH: Antepartum hemorrhage; CI: Confidence interval; OR: Odds ratio; PP: Placenta previa.
mechanical stretch between the placenta and uterus, the likelihood of bleeding during pregnancy. Attachment
leading to bleeding that can complicate the pregnancy to the lower segment of the uterus, where the thickness
and thus undesirable outcomes. The uterine stretch at the of myometrium is significantly lower, compromises
placental site continues to increase in the latter half of the stable environment where the placenta grows, and
pregnancy, thus posing a risk of rupture of the maternal additionally, as the pregnancy progresses, there is a
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blood vessels that can cause hemorrhage. Furthermore, substantial expansion in the lower segment, which leads
uterine contractions, premature cervical changes, and the to increased stress. This disrupts the decidua basalis – a
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type of PP can influence the likelihood of hemorrhage. thin and poorly vascularized membrane susceptible to
Patients with complete PP are associated with a higher risk detachment from mechanical stress – which plays a crucial
of bleeding and more complications as compared to other role in placental attachment, thereby compromising the
types because in this condition, the entire cervical os of the maternal blood vessels in intervillous space. Furthermore,
affected patients is covered. 1,13,17 cervical dilation and uterine contractions augment the
The aberrant attachment of PP predisposes it to risk of vascular compromise. Separately, higher fibrin
vascular compromise and mechanical stress, increasing deposition, maternal malperfusion, and chronic hypoxia

Volume 11 Issue 3 (2025) 74 doi: 10.36922/jctr.25.00002