Comparison of obstetric, neonatal, and surgical outcomes of emergency and planned deliveries in pregnancies complicated by placenta previa and in subgroups with and without placenta accreta spectrum.

Abstract

Objective: This study aimed to compare emergency and planned cesarean section cases in pregnancies complicated with placenta previa (PP) and subgroups with and without placenta accreta spectrum (PAS) in terms of obstetric, neonatal, and surgical outcomes.

Materials and methods: This retrospective cohort study included 128 patients diagnosed with PP who underwent cesarean section. Obstetric, neonatal, and surgical outcomes of all cases with PP and subgroups with and without PAS were compared according to whether they were emergency or planned cesarean section.

Results: Of the 128 women with PP, 60 planned and 68 underwent emergency cesarean section. In all patients with PP and in the PAS and non-PAS subgroups, the neonatal outcomes of patients who underwent emergency cesarean section were more negative than those of patients who underwent planned cesarean section. It was observed that more hysterectomy were performed in the emergency group than in the elective group in all patients with PP and PAS patients (p=0.027 and p=0.012 respectively). It was observed that patients with PP and non-PAS were hospitalized after cesarean section for a longer period of time in the emergency group than in the planned group (p=0.044 and p=0.002 respectively).

Conclusion: Planned cesarean section leads to better obstetric, neonatal, and surgical outcomes compared with emergency cesarean section in pregnancies complicated by PP, especially in those with PAS. Our findings suggest that planned delivery strategies should be considered for patients with PP. Decisions regarding the timing of delivery should balance maternal risks and benefits with fetal and fetal risks and benefits.