EXPECTANT MANAGEMENT OF PLACENTA PREVIA - COST-BENEFIT-ANALYSIS OF OUTPATIENT TREATMENT

OBJECTIVE: In this study outpatient and inpatient expectant management for complete placenta previa were compared in terms of maternal and n eonatal outcome and overall cost. STUDY DESIGN: We reviewed the outcom es and hospital costs of 72 mother-infant pairs where the pregnancy wa s complicated by second- or third-trimester placenta previa and was ma naged expectantly either with hospitalization or outpatient bed rest. The data were analyzed with the two-sided unpaired t test, chi(2), and simple correlation analysis. RESULTS: There were no differences in ma ternal morbidity as measured by estimated total blood loss, number of blood transfusions, nadir hematocrit, or need for emergency delivery. Fetal mortality was comparable in both groups, and there were no signi ficant differences in neonatal morbidity as measured by gestational ag e, birth weight, 5-minute Apgar score, or occurrence of fetal distress . Among outpatients the number of maternal hospital days was reduced b y 50% (p < 0.01). outpatient management achieved a hospital cost reduc tion of 48.5% for mothers (p < 0.001) and 39.4% for mother-infant pair s (p < 0.05). CONCLUSION: In selected patients outpatient management o f complete placenta previa can be cost-effective and safe.