Plazentalokalisationen in aufeinanderfolgenden Schwangerschaften – eine retrospektive Kohortenstudie

Zusammenfassung

Einführung Die Plazentalokalisation ist mit Risiken während einer Schwangerschaft (SS) und Geburt assoziiert. Kenntnisse über die Lage der Plazenta ermöglichen eine auf Risikofaktoren angepasste weitere Betreuung der SS. Verschiedene Studien beschreiben ein höheres Risiko für eine wiederholte Plazenta prävia, gleichartige Daten zu anderen Plazentalokalisationen fehlen. Ziel dieser Studie war es, die Häufigkeitsverteilung der verschiedenen Plazentalokalisationen zu evaluieren und Korrelationen zwischen Plazentalokalisationen in aufeinanderfolgenden SS zu analysieren.

Material und Methodik In einer retrospektiven Kohortenstudie wurden Frauen mit Einlings-SS ≥ 24+0 Schwangerschaftswochen (SSW), mindestens 1 Ultraschalluntersuchung zur Identifikation der Plazentalokalisation sowie Geburt ihres Erstgeborenen und mindestens eines direkt aufeinanderfolgenden Kindes in unserer Klinik zwischen 2007 und 2016 analysiert. Ausschlusskriterien waren Mehrlingsschwangerschaften, Aborte/intrauteriner Fruchttod/Frühgeburten <24+0 SSW.

Resultate Unter 1657 Frauen befand sich die Plazenta am häufigsten anterior gefolgt von posterior, fundal, lateral und dann als prävia. Es zeigten sich keine statistisch signifikanten Korrelationen bezüglich der Plazentalokalisationen in aufeinanderfolgenden SS und kein signifikanter Einfluss einer vorangegangen Curettage oder Sectio.

Konklusion Die Plazentalokalisation scheint nicht durch den Plazentasitz in der vorherigen Schwangerschaft beeinflusst zu werden. Daher kann keine Prognose hinsichtlich der Plazentalokalisation in aufeinanderfolgenden Schwangerschaften gestellt werden.

Abstract

Introduction Different locations of the placenta are associated with specific risks during pregnancy and labor. Knowledge of the placental location helps to provide better care for the expectant mother and her unborn child. Whereas multiple studies show a higher risk for a recurrent placenta previa, hardly any such data is available for any other placental location. The aim of this study was to analyze the frequency of distribution of different placental locations and to evaluate correlations between placental locations in subsequent pregnancies.

Material and Methods In a retrospective cohort study women with singleton pregnancies ≥ 24 gestational weeks who had at least one ultrasound with identification of the placental location and gave birth to their firstborn and at least one more following child at our hospital between 2007 and 2016 were evaluated. Exclusion criteria were multiple pregnancies, abortions, intrauterine fetal death, and fetal malformations. Placental locations were classified into anterior, posterior, fundal, right, left, and previa.

Results Data of 1657 women were analyzed. The most frequent location was anterior, followed by posterior, fundal and lateral, and previa. Statistical analysis showed no significant correlations in subsequent pregnancies regarding placental locations.

Conclusion Placental locations in subsequent pregnancies seem not to be influenced by previous pregnancies. Therefore no prognosis for placental location can be made concerning future pregnancies.

Schlüsselwörter

Plazenta - Plazentalokalisation - aufeinanderfolgende Schwangerschaften - Plazenta prävia - Ultraschall

Key words

Placenta - placental location - subsequent pregnancies - placenta previa - ultrasound

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