From the Guidelines
Association Between Resolved Low-Lying Placentation and Postpartum Hemorrhage Risk
Resolved low-lying placentation, also known as placenta previa, is significantly associated with an increased risk of postpartum hemorrhage (PPH) [ 1 ].
- The risk of PPH is higher in women with a history of placenta previa due to the potential for abnormal placental implantation and invasion [ 1 ].
- Women with placenta previa and prior cesarean deliveries are at a higher risk of developing placenta accreta spectrum, which can lead to severe PPH [ 1 ].
- The management of women with resolved low-lying placentation should involve increased vigilance for PPH, with potential interventions including prophylactic oxytocin administration (10-20 units) during the third stage of labor [ 1 ].
- A comprehensive multidisciplinary care team and established infrastructure for managing high-level postpartum hemorrhage are essential for optimal outcomes in women with a history of low-lying placentation [ 1 ].
- Key risk factors for placenta accreta spectrum, which can contribute to PPH, include previous cesarean delivery, advanced maternal age, multiparity, prior uterine surgeries or curettage, and Asherman syndrome [ 1 ].
- Uterotonic medications like oxytocin (20-30 units) or carboprost tromethamine (0.25mg) may be required to manage PPH in women with resolved low-lying placentation [ 1 ].