Placenta previa: hospital observation or outpatient management

Women with placenta previa are at an increased risk of adverse maternal, fetal, and neonatal outcomes, including antepartum and intrapartum hemorrhage, necessitating urgent surgical delivery, often before fetal maturity. Optimizing the management algorithm considering risk factors for obstetric complications has the potential to improve maternal and neonatal outcomes. Aim - to identify and analyze risk factors for antepartum hemorrhage to justify the timing of planned hospitalization. Materials and methods. A retrospective analysis of 21,390 birth histories of pregnant women between 22 and 41 weeks of gestation at the Municipal Non-Profit Enterprise "Perinatal Center of Kyiv". The study considered a history of uterine surgeries, including cesarean section, pregnancy resulting from assisted reproductive technologies, placental location, and previous childbirth history. Results. The presence of prior uterine surgeries, including cesarean section, as well as anterior placental location, increases the risk of placenta accreta, antepartum hemorrhage, and urgent preterm delivery. Conclusions. Based on the analysis, specific risk factors were identified, allowing differentiation between pregnant women who, without a high risk of complications, can be monitored on an outpatient basis and those for whom inpatient management is preferable. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.