Second-trimester placental location and postpartum hemorrhage

Sarah S. Osmundson*, Amy E. Wong, Susan E. Gerber

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Objectives - The purpose of this study was to assess whether low placentation in the second trimester is an independent risk factor for postpartum hemorrhage. Methods - A retrospective cohort study of women undergoing transvaginal sonography between 18 weeks' and 23 weeks 6 days' gestation was conducted. Patients were subdivided into three groups: low-lying placenta (0.1-2.5 cm), marginal previa (touching but not overlapping the os), and complete previa (covering the os). Low placentation was used as a descriptive for all cases (low-lying placenta, marginal previa, and complete previa) in this study. A group of randomly identified control patients with normal placentation was selected for comparison. Results - During the period of study, 410 women with low placentation were identified. Compared to controls, patients with second-trimester low placentation had increased rates of postpartum hemorrhage and uterotonic use. These increased risks persisted even among women in whom the low placentation resolved (odds ratio, 2.72; 95% confidence interval, 1.46-5.07; odds ratio, 2.18; 95% confidence interval, 1.24-3.84). Conclusions - Women with a second-trimester diagnosis of low placentation are at increased risk of postpartum hemorrhage.

Original languageEnglish (US)
Pages (from-to)631-636
Number of pages6
JournalJournal of Ultrasound in Medicine
Issue number4
StatePublished - Apr 1 2013


  • Low-lying placenta
  • Postpartum hemorrhage
  • Previa
  • Resolution

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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