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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto

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CiteScore 2017: 1.26

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Volume 36, Issue 6


Blood loss in low-lying placenta: placental edge to cervical internal os distance of less vs. more than 2 cm

Shigeki Matsubara / Akihide Ohkuchi / Masashi Kikkawa / Akio Izumi / Tomoyuki Kuwata / Rie Usui / Takashi Watanabe / Mitsuaki Suzuki
Published Online: 2008-08-04 | DOI: https://doi.org/10.1515/JPM.2008.089


Objective: To reconfirm that a low-lying placenta, with placental edge-internal os distance of 0–4 cm, is a risk factor for blood loss during delivery, and to determine whether blood loss differs between edge-os distance of ≤2 cm vs. >2 cm.

Methods: We compared total blood loss between 73 singleton pregnant women with edge-os distance of 0–4.0 cm vs. controls. We also compared total blood loss between pregnant women with distance of 0–2.0 cm (lower) vs. 2.1–4.0 cm (higher).

Results: Total blood loss was significantly greater in women with placental edge-os distance of ≤4 cm than controls in both delivery modes. The lower group showed a significantly higher incidence of excessive hemorrhage during vaginal delivery (60 vs. 19%, P=0.046) and bled more (median 1240 vs. 860 mL, P=0.059) than the higher group. Although this did not reach statistical significance, the lower group more frequently bled antepartum, required emergent cesarean section, and delivered abdominally. Regression analysis showed no association between the amount of blood loss and the edge-os distance in both delivery modes.

Conclusion: Pregnant women with edge-os distance of 2.1–4.0 cm are of highest level of concern as are women with 0–2.0 cm distance.

Keywords: Cesarean section; low-lying placenta; placental edge; placenta previa

About the article

Corresponding author: Shigeki Matsubara, MD Department of Obstetrics and Gynecology Jichi Medical University 3311-1 Yakushiji Shimotsuke Tochigi, 329-0498 Japan Tel.: +81-285-58-7376 Fax: +81-285-44-8505

Received: 2008-03-21

Revised: 2008-05-30

Accepted: 2008-06-05

Published Online: 2008-08-04

Published Online: 2008-08-04

Published in Print: 2008-11-01

Citation Information: Journal of Perinatal Medicine, Volume 36, Issue 6, Pages 507–512, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2008.089.

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