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Manejo ambulatorio de la paciente con placenta previa revisión sistemática

Keywords: placenta previa, management, outpatient and inpatient, perinatal outcome, neonatal outcome.

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Abstract:

placenta previa is an important obstetric complication in terms of maternal and foetal morbidity-mortality, having a high incidence in our population. many interventions have been proposed for managing this pathology to minimise risks, recourse to hospital stay being a usual preventative action. these problems, apart from being costly, cause patients to become subjected to permanent medical care and high emotional tension. objective: reviewing perinatal outcome and outpatient management cost effectiveness in placenta previa. materials and methods: an electronic search was performed to identify relevant literature. searched databases included medline, ebsco, scopus, scielo (1980 to 2006) and cochrane pregnancy and childbirth group (september 15th 2006). any controlled clinical trial which had assessed perinatal outcome in placenta previa outpatient management and any study regarding the cost-benefits of such intervention. results: one perinatal outcome trial was included. there was no difference in maternal or neonatal outcome, reduced length of stay in hospital being the only difference. two studies assessed the cost-benefits of outpatient management, demonstrating contrary results. conclusions: there is insufficient trial data to recommend any change in clinical practice. however, available data showed that outpatient management could be a safe and cost-benefit option for selected patients. outpatient management appeared to be a safe and cost-effective therapeutic option.

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