alexa Acute and massive bleeding from placenta previa and infants' brain damage.
Clinical Research

Clinical Research

Journal of Clinical Research & Bioethics

Author(s): Furuta K

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BACKGROUND: Among the causes of third trimester bleeding, the impact of placenta previa on cerebral palsy is not well known. AIMS: To clarify the effect of maternal bleeding from placenta previa on cerebral palsy, and in particular when and how it occurs. STUDY DESIGN: A descriptive study. SUBJECTS: Sixty infants born to mothers with placenta previa in our regional population-based study of 160,000 deliveries from 1998 to 2012. Premature deliveries occurring at<26 weeks of gestation and placenta accreta were excluded. OUTCOME MEASURES: Prevalence of cystic periventricular leukomalacia (PVL) and cerebral palsy (CP). RESULTS: Five infants had PVL and 4 of these infants developed CP (1/40,000 deliveries). Acute and massive bleeding (>500g within 8h) occurred at around 30-31 weeks of gestation, and was severe enough to deliver the fetus. None of the 5 infants with PVL underwent antenatal corticosteroid treatment, and 1 infant had mild neonatal hypocapnia with a PaCO2 <25mmHg. However, none of the 5 PVL infants showed umbilical arterial acidemia with pH<7.2, an abnormal fetal heart rate monitoring pattern, or neonatal hypotension. CONCLUSIONS: Our descriptive study showed that acute and massive bleeding from placenta previa at around 30 weeks of gestation may be a risk factor for CP, and requires careful neonatal follow-up. The underlying process connecting massive placental bleeding and PVL requires further investigation.

This article was published in Early Hum Dev and referenced in Journal of Clinical Research & Bioethics

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