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Indications for, timing of, and modes of delivery in a national cohort of women admitted with antepartum hemorrhage at 22+0 to 28+6 weeks' gestation.

Sabourin, JN; Lee, T; Magee, LA; von Dadelszen, P; Demianczuk, N (2012) Indications for, timing of, and modes of delivery in a national cohort of women admitted with antepartum hemorrhage at 22+0 to 28+6 weeks' gestation. Journal of Obstetrics and Gynaecology Canada, 34 (11). pp. 1043-1052. ISSN 1701-2163 https://doi.org/10.1016/S1701-2163(16)35434-2
SGUL Authors: von Dadelszen, Peter

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Abstract

OBJECTIVE: Antepartum hemorrhage is associated with preterm birth and operative delivery. Since the Canadian Perinatal Network records obstetric interventions for women admitted to tertiary care hospitals with antepartum hemorrhage, our objective was to describe the delivery characteristics of this cohort. METHODS: Trained abstractors collected data by chart review from women admitted with antepartum hemorrhage between 22+0 and 28+6 weeks' gestation. We included all women with complete follow-up postpartum and used descriptive statistics to report the indications for, timing of, and modes of delivery. RESULTS: The study cohort included 806 women from 13 tertiary perinatal centres in six provinces. The most common causes of bleeding were placental abruption (n = 256) and placenta previa (n = 171). The median gestational age at delivery was 30 weeks, and 497 (61.7%) births occurred at less than 34 weeks. Over one half of the women began labour spontaneously, and 238 (29.5%) were delivered prior to the onset of labour. Overall, 370 (45.9%) women delivered vaginally, including 98 who had induction of labour. Of the 436 Caesarean sections (54.1%), 345 (79.1%) were emergencies. The most common indications for Caesarean section were placenta previa, abnormal fetal presentation, and placental abruption or vaginal bleeding. CONCLUSION: This inpatient cohort of women with antepartum hemorrhage had high rates of spontaneous labour, preterm birth, and emergency Caesarean section. These results can be used as current Canadian benchmark rates of preterm delivery, induction of labour, and Caesarean section in women admitted to tertiary care centres with antepartum hemorrhage between 22+0 and 28+6 weeks' gestation, and can aid in the counselling of similar women.

Item Type: Article
Additional Information: © 2012 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved. Made available with permission from the publisher. Contact publisher for any further re-use.
Keywords: Abruptio Placentae, Canada, Cesarean Section, Cohort Studies, Delivery, Obstetric, Female, Gestational Age, Humans, Labor, Induced, Obstetric Labor, Premature, Placenta Previa, Pregnancy, Pregnancy Complications, Premature Birth, Uterine Hemorrhage, Humans, Uterine Hemorrhage, Pregnancy Complications, Abruptio Placentae, Premature Birth, Delivery, Obstetric, Cesarean Section, Labor, Induced, Cohort Studies, Gestational Age, Pregnancy, Canada, Female, Obstetric Labor, Premature, Placenta Previa, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Journal of Obstetrics and Gynaecology Canada
ISSN: 1701-2163
Language: eng
Dates:
DateEvent
1 November 2012Published
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
UNSPECIFIEDCanadian Institutes of Health ResearchUNSPECIFIED
PubMed ID: 23231842
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107520
Publisher's version: https://doi.org/10.1016/S1701-2163(16)35434-2

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