The Placenta Previa and Fetal Weight

The Effect of Placenta Previa on Fetal Weight and Feto-maternal Blood Flow

Placenta previa is a placenta that implants at lower uterine segment, it occurs in about 0.3-0.5% of pregnancies at term. It is a significant risk for development of maternal morbidity, as well as maternal mortality secondary to maternal hemorrhage . Also, this abnormal placenta has a negative concern about fetal well being due to prematurity and perinatal mortality, in addition to its undesirable effect on fetal growth. Several factors may be behind of the effect of placenta previa on fetal growth. Firstly, the blood supply to the lower uterine segment is less than at the upper segment apparently resulting in less feto-placental blood perfusion . Secondly, recurrent bleeding attacks from placental previa may affect fetal oxygenation and fetal growth.

In spite of above evidences; many studies in literature denied the relation between placenta previa and fetal growth and concluded that the association between low birth weight and placenta previa is mainly due to preterm delivery and to a lesser extent with fetal growth restriction. However; the major drawback of all these studies is lacking of reporting the effect of placenta previa of feto-maternal blood flow representing in studying of Doppler blood flow in both uterine and umbilical artery in those patients. The uterine artery blood flow is usually affected by the presence of placenta previa and placenta accreta which reflected on feto-placental blood flow. So the uterine artery Doppler velocimetry is a useful tool for predicting placenta accreta .

So in the light of above evidences; we aimed, in the current study, not only to investigate the effect on placenta previa on fetal weight but also to walk around the effect of placenta previa on the uterine and umbilical arteries blood flow in trial to explore this conflicting issue. To our knowledge, no previous trial had studied this interesting subject before.

Study Overview

• Status: Completed
• Conditions: Placenta Previa
• Intervention / Treatment: Other: placenta previa patient; Other: normal women

• Study Type: Observational
• Enrollment (Actual): 200

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 35 years (ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

• Sampling Method: Non-Probability Sample

Study Population

placenta previa patients

Description

Inclusion Criteria:

1. Women who are sure of her pregnancy.
2. Women aged 20-35 years.
3. Women with BMI 18-22 kg/m2.
4. Estimated gestational age is ranging between 30- 32 weeks gestation.
5. Singleton pregnancy.
6. Placenta previa; either major or minor degrees as regard the cases.
7. Placenta previa with minimal vaginal bleeding or haven't any vaginal bleeding.
8. Women with normal Doppler indices in uterine and umbilical arteries at time of recruitment.
9. Women should be living in a nearby area to make follow-up and early transportation are reasonably possible.

Exclusion Criteria:

1. Women aged < 20 and >35 years.
2. Smoker ≥ 11 cigarettes/day.
3. Severe attack of bleeding requiring an immediate intervention.
4. Fetal heart rates instability or non reassuring.
5. Multiple gestations.
6. Previous Intrauterine growth restricted fetus.
7. Intrauterine fetal death or major fetal anomalies.
8. If associated with abruptio placentae.
9. Patients with known bleeding disorders or on anticoagulant therapy

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
placenta previa group	Other: placenta previa patient; women had placenta previa either major or minor degree
Normal control group	Other: normal women; those women had not placenta previa

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Estimated fetal wight (gram)	4 weeks

Secondary Outcome Measures

Outcome Measure	Time Frame
The value of Doppler indices in uterine artery	4 weeks

Collaborators and Investigators

• Sponsor: Assiut University

Study record dates

Study Major Dates

• Study Start (ACTUAL): October 1, 2016
• Primary Completion (ACTUAL): August 1, 2017
• Study Completion (ACTUAL): October 1, 2017

Study Registration Dates

• First Submitted: October 21, 2017
• First Submitted That Met QC Criteria: October 24, 2017
• First Posted (ACTUAL): October 25, 2017

Study Record Updates

• Last Update Posted (ACTUAL): November 17, 2017
• Last Update Submitted That Met QC Criteria: November 14, 2017
• Last Verified: November 1, 2017

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Body Weight; Pregnancy Complications; Obstetric Labor Complications; Placenta Diseases; Fetal Weight; Placenta Previa
• Other Study ID Numbers: PPIUGR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No