The effect of placenta previa on fetal weight and feto-maternal blood flow: a prospective cohort study

Mohammed K. Ali, Islam S. Mahfouz, Ahmed M. Abbas, Ezzat H. Sayed


Background: The current study aims to evaluate the effect of placenta previa on the fetal weight and to explore its effect on the uterine and umbilical arteries blood flow.

Methods: The current study was a prospective cohort study conducted at Assiut Women’s Health Hospital, Egypt from 1st of October 2016 to 30th of September 2017 including placenta previa and non-placenta previa women. They were followed up by two-dimensional ultrasound and Doppler blood flow in the uterine and umbilical arteries. The main study outcome was the number of low birth weight (LBW) babies delivered at or beyond 37 weeks and blood flow changes in uterine and umbilical arteries.

Results: Two hundred twelve women were divided into two groups; group I included 106 placenta previa women (PP group) and 106 non-placenta previa women (NPP group). The number of LBW babies were comparable in both groups without statistically significant difference (P value= 0.555). Neither; uterine artery nor umbilical artery blood flow had any significant differences between the groups.  Preterm delivery was significantly higher in the PP group (p value=0.000).

Conclusions: Although there is no agreement, in the literature, on the association between placenta previa and LBW, authors suggest that placenta previa is not a reason for LBW babies. In addition, placenta previa shows no effect on uterine artery or umbilical artery blood flow.


Doppler blood flow, Low birth weight, Placenta previa, Preterm birth

Full Text:



Mohamed MA, Mohammed AH. Parallel vertical compression sutures to control bleeding in cases of placenta previa and accreta. J Matern Fetal Neonatal Med. 2017;16:1-5.

Umazume T, Hayasaka S, Kato F, Ishikawa S, Morikawa M, Minakami H. Sudden maternal hypoxemia during elective cesarean section in a woman with placenta previa. Clin Case Rep. 2017;5(10):1668-71.

Harper LM, Odibo AO, Macones GA, Crane JP, Cahill AG. Effect of placenta previa on fetal growth. Am J Obstet Gynecol. 2010;203(4):330.e1-5.

Soyama H, Miyamoto M, Ishibashi H, Takano M, Sasa H, Furuya K. Relation between Birth Weight and Intraoperative Hemorrhage during Cesarean Section in Pregnancy with Placenta Previa. PLoS One. 2016;11(11):e0167332.

Weiner E, Miremberg H, Grinstein E, Mizrachi Y, Schreiber L, Bar J, et al. The effect of placenta previa on fetal growth and pregnancy outcome, in correlation with placental pathology. J Perinatol. 2016;36(12):1073-8.

Rosenberg T, Pariente G, Sergienko R, Wiznitzer A, Sheiner E. Critical analysis of risk factors and outcome of placenta previa. Arch Gynecol Obstet. 2011;28:47-51.

Yeniel AO, Ergenoglu AM, Itil IM, Askar N, Meseri R. Effect of placenta previa on fetal growth restriction and stillbirth. Arch Gynecol Obstet. 2012;286(2):295-8.

Kollmann M, Gaulhofer J, Lang U, Klaritsch P. Placenta praevia: incidence, risk factors and outcome. J Matern Fetal Neonatal Med. 2016;29(9):1395-8.

Weiner E, Miremberg H, Grinstein E, Schreiber L, Ginath S, Bar J, et al. Placental histopathology lesions and pregnancy outcome in pregnancies complicated with symptomatic vs. non-symptomatic placenta previa. Early Hum Dev. 2016;101:85-9.

Ananth CV, Demissie K, Smulian JC, Vintzileos AM. Relationship among placenta previa, fetal growth restriction, and preterm delivery: a population-based study. Obstet Gynecol. 2001;98(2):299-306.

Shady NW, Sallam HF, Abbas AM. Placenta accreta and emergency cesarean delivery correlates to cervical length and transcervical placental thickness measurement. Int J Reprod Contracept Obstet Gynecol. 2017;6:4808-13.

Poon LC, Volpe N, Muto B, Yu CK, Syngelaki A, Nicolaides KH. Second-trimester uterine artery Doppler in the prediction of stillbirths. Fetal Diagn Ther. 2013;33:28-35.

Cho HY, Hwang HS, Jung I, Park YW, Kwon JY, Kim YH. Diagnosis of placenta accreta by uterine artery Doppler velocimetry in patients with placenta previa. J Ultrasound Med. 2015;34(9):1571-5.

Ali MK, Amin ME, Amin AF, Abd El Aal DEM. Evaluation of the effectiveness of lowdose aspirin and omega 3 in treatment of asymmetrically intrauterine growth restriction: A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2017;210:231-5.

Royal College of Obstetricians and Gynaecologists. The Investigation and Management of the Small-for-Gestational-Age. Green-top Guideline No. 31. London: RCOG; 2014.

Royal College of Obstetricians and Gynaecologists. Placenta Praevia, Placenta Praevia Accreta and Vasa Praevia: Diagnosis and Management. Green-top Guideline No.27. London: RCOG; 2011.

Ali MK, Abbas AM, Yosef AH, Bahloul M. The effect of low-dose aspirin on fetal weight of idiopathic asymmetrically intrauterine growth restricted fetuses with abnormal umbilical artery Doppler indices: a randomized clinical trial. J Matern Fetal Neonatal Med. 2017;11:1-6.

Ferdos J, Rahman MM. Maternal experience of intimate partner violence and low birth weight of children: a hospital-based study in Bangladesh. PLoS One. 2017;12(10):e0187138.

Black RE, Allen LH, BhuttaZA. Maternal and child under nutrition: global and regional exposures and health consequences. Lancet. 2008;371:243-60.

Shariat M, Gharaee J, Dalili H, Mohammadzadeh Y, Ansari S, Farahani Z. Association between small for gestational age and low birth weight with attention deficit and impaired executive functions in 3-6 years old children. J Mat Fetal Neonatal Med. 2017;1:1-4.

Björkqvist J, Hovi P, Pesonen AK, Räikkönen K, Heinonen K, Järvenpää AL, et al. Adults who were born preterm with a very low birth weight reported a similar health-related quality of life to their term-born peers. Acta Paediatr. 2018;107(2):354-7.

Takahashi H, Ohkuchi A, Usui R, Suzuki H, Baba Y, Matsubara S. Matsubara-Takahashi cervix-holding technique for massive postpartum hemorrhage in patients with placenta previa with or without placenta accreta spectrum disorders. Int J Gynaecol Obstet. 2018;140:357-64.

Shazly SA, Badee AY, Ali MK. The use of multiple 8 compression suturing Asa novel procedure to preserve fertility in patients with placenta accreta: case series. Aus NZJ Obstet Gynaecol. 2012;52(4):395-9.

Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PloS One. 2016;11(2):e0148343.

To WW, Leung WC. Placenta previa and previous cesarean section. Int J Gynaecol Obstet. 1995;51(1):25-31.

Hendricks MS, Chow YH, Bhagavath B, Singh K. Previous cesarean section and abortion as risk factors for developing placenta previa. J Obstet Gynaecol Res. 1999;25(2):137-42.

Getahun D, Oyelese Y, Salihu HM, Ananth CV. Previous cesarean delivery and risks of placenta previa and placental abruption. Obstet Gynecol. 2006;107(4):771-8.

Yang Q, Wen SW, Phillips K, Oppenheimer L, Black D, Walker MC. Comparison of maternal risk factors between placental abruption and placenta previa. Am J Perinatol. 2009;26(4):279-86.

Sekiguchi A, Nakai A, Kawabata I, Hayashi M, Takeshita T. Type and location of placenta previa affect preterm delivery risk related to antepartum hemorrhage. Int J Med Sci. 2013;10(12):1683-8.

Qiu Z, Hu J, Wu J, Chen L. Prophylactic temporary abdominal aorta balloon occlusion in women with placenta previa accretism during late gestation. Med (Baltimore). 2017;96(46):e8681.

Hebbar SS, Rai L, Zainab R, Guruvare S, Adiga P, Mundkur A. Influence of placental position on obstetric morbidity in placenta previa. Int J Reprod Contracept Obstet Gynecol. 2014;3:585-91.

Kumari SJ, Bhavani V, Himabindu S, Madhumitha M. Placental migration in mid trimester low-lying placenta. IOSR-JDMS. 2016;15(1):150-6.

Hong DH, Kim E, Kyeong KS, Hong SH, Jeong EH. Safety of cesarean delivery through placental incision in patients with anterior placenta previa. Obstet Gynecol Sci. 2016;59(2):103-9.

Ishibashi H, Miyamoto M, Shinnmoto H, Murakami W, Soyama H, Nakatsuka M, et al. Cervical varicosities may predict placenta accreta in posterior placenta previa: a magnetic resonance imaging study. Arch Gynecol Obstet. 2017;296(4):731-6.

Vahanian SA, Lavery JA, Ananth CV, Vintzileos A. Placental implantation abnormalities and risk of preterm delivery: a systematic review and metaanalysis. Am J Obstet Gynecol. 2015;213(4 Suppl):S78-90.

Bernstein IM, Horbar JD, Badger GJ, Ohlsson A, Golan A. Morbidity and mortality among very-low-birth-weight neonates with intrauterine growth restriction. Am J Obstet Gynecol. 2000;182:198-206.