Dmb. Rosen et Mj. Peek, DO WOMEN WITH PLACENTA PREVIA WITHOUT ANTEPARTUM HEMORRHAGE REQUIRE HOSPITALIZATION, Australian and New Zealand Journal of Obstetrics and Gynaecology, 34(2), 1994, pp. 130-134
Patients with placenta praevia in the third trimester are routinely co
nfined to hospital for fear of major haemorrhage. Whilst this is argua
bly necessary for those who have had an episode of antepartum haemorrh
age (APH), it is uncertain whether these same management principles ar
e valid for those with placenta praevia without antepartum haemorrhage
. A retrospective study was undertaken reviewing the case records of 6
9 consecutive patients diagnosed with placenta praevia in the third tr
imester of pregnancy. The outcome of 15 who had had no episodes of ble
eding were compared with those who had at least 1 antepartum bleeding
episode. Patients with placenta praevia without evidence of APH spent
a significantly shorter amount of time in hospital and had a significa
ntly lower rate of emergency delivery, with a neonatal outcome as good
if not better than the APH group. We conclude that outpatient managem
ent in this cohort of patients may be a safe and cost-effective means
of care, and warrants randomized prospective study.