Neonatal outcomes in planned versus emergency cesarean deliveries for placenta praevia

Abstract

Introduction and aims of the study: The aim of this study was to investigate neonatal outcome differences between planned (PCD) and emergency cesarean delivery (ECD) for women with placenta praevia (PP). Methods: A retrospective cohort study was conducted in a tertiary referral hospital between 2015 and 2022. PP patients who were delivered at the scheduled time were included in the PCD group (n=94). Participants with PP delivered in an emergency setting were assigned to the ECD group (n=58). Neonatal outcomes as prematurity, APGAR score, birth weight were compared between two groups. Results: Median APGAR score in PCD was 8 (2–10) 1 minute after birth and 9 (6–10) 5 minutes after birth. ECD was significantly associated with lower APGAR scores 1 (p=0.039) and 5 (p=0.013) minutes after birth. General anesthesia during cesarean delivery was associated with lower APGAR scores 1 (p=0.002) and 5 (p=0.02) minutes after birth compared to regional anesthesia. ECD was significantly associated with prematurity (28.7 % vs 62.1 %, p<0.001). Median gestational age during delivery was shorter in ECD (35 (24–41) weeks) compared to PCD (37 (33–40) weeks), p<0.001. Higher rates of intrauterine growth restriction (IUGR) were noticed in the ECD group (4.3 % vs 19.0 %, p=0.003). Median birth weight in the ECD group was 2517 (544–3980) grams, significantly lower (p<0.001) compared to PCD (median 3230 (1780–4275) grams). The ECD group was associated with admission to neonatal intensive care unit (NICU) (11.7 % vs 27.6 %, p=0.013). Perinatal death rates did not differ between the groups (0.0 % vs 3.4 %, p=0.07). Two cases of perinatal death that occurred in the ECD group were related to severe prematurity. Conclusions: Better neonatal outcomes as higher APGAR scores, higher median birth weight, lower rates of prematurity and IUGR were associated with PCD compared with ECD. Admission to NICU, prematurity rate did not differ between the groups.