Acute and massive bleeding from placenta previa and infants%26apos; brain damage

作者：Furuta Ken; Tokunaga Shuichi; Furukawa Seishi; Sameshima Hiroshi^*

来源：Early Human Development, 2014, 90(9): 455-458.

DOI：10.1016/j.earlhumdev.2014.06.002

• Cerebral palsy
• Placenta previa
• Periventricular leukomalacia
• Third trimester bleeding

Background: Among the causes of third trimester bleeding, the impact of placenta previa on cerebral palsy is not well known. %26lt;br%26gt;Aims: To clarify the effect of maternal bleeding from placenta previa on cerebral palsy, and in particular when and how it occurs. %26lt;br%26gt;Study design: A descriptive study. %26lt;br%26gt;Subjects: Sixty infants born to mothers with placenta previa in our regional population-based study of 160,000 deliveries from 1998 to 2012. Premature deliveries occurring at%26lt;26 weeks of gestation and placenta accreta were excluded. %26lt;br%26gt;Outcome measures: Prevalence of cystic periventricular leukomalacia (PVL) and cerebral palsy (CP). %26lt;br%26gt;Results: Five infants had PVL and 4 of these infants developed CP (1/40,000 deliveries). Acute and massive bleeding (%26gt;500 g within 8 h) occurred at around 30-31 weeks of gestation, and was severe enough to deliver the fetus. None of the 5 infants with PVL underwent antenatal corticosteroid treatment, and 1 infant had mild neonatal hypocapnia with a PaCO2 %26lt;25 mm Hg. However, none of the 5 PVL infants showed umbilical arterial acidemia with pH%26lt;7.2, an abnormal fetal heart rate monitoring pattern, or neonatal hypotension. %26lt;br%26gt;Conclusions: Our descriptive study showed that acute and massive bleeding from placenta previa at around 30 weeks of gestation may be a risk factor for CP, and requires careful neonatal follow-up. The underlying process connecting massive placental bleeding and PVL requires further investigation.

• 出版日期2014-9