Preterm Birth Risk in Placenta Previa and Low-Lying Placenta: A Systematic Review of Preventive Interventions

Abstract

Background: This systematic review aims to assess the risk of preterm birth before 37, 34, 32, and 28 weeks of gestation in women with placenta previa or low-lying placenta, and to evaluate the effectiveness of preventive interventions like cerclage, pessary, and progesterone in reducing preterm birth in these cases.  Methods: This review follows the PRISMA 2020 guidelines. Studies from 2014-2024 published in English, peer-reviewed, and with a DOI were included. Results: Five key studies were included in the review. They demonstrated that women with placenta previa, especially those with complete previa or placenta accreta spectrum disorder, are at higher risk for preterm birth and associated maternal and neonatal complications. Interventions like the use of cervical pessary and progesterone therapy significantly reduced the risk of preterm labor before 34 weeks. Conclusion: The review highlights the elevated risks in pregnancies complicated by placenta previa and low-lying placenta. While preventive measures such as cervical pessary and progesterone show potential, further research is required to confirm their efficacy. Early diagnosis and tailored management based on individual risk factors are crucial for improving maternal and neonatal outcomes.