title: Evaluating the safety of labour in women with a placental edge 11 to 20 mm from the internal cervical Os.
abstract: OBJECTIVE
  The purpose of this study was to evaluate pregnancy outcomes in a cohort of women with a placental edge between 11 and 20 mm from the internal cervical os, and to determine the likelihood of a successful vaginal delivery when trial of labour is attempted in these women.
  
  
  METHODS
  We carried out a prospective observational study of women with singleton pregnancies and a placental edge between 11 and 20 mm from the internal cervical os (identified by transvaginal sonography) who underwent a trial of labour.
  
  
  RESULTS
  Fourteen women with the above characteristics underwent a trial of labour during the study period. The mean interval (± SD) from ultrasound to delivery was 17.2 ± 9.6 days. Thirteen women (92.9%) delivered vaginally with no complications, and only one woman (7.1%) required an emergency Caesarean section for intrapartum bleeding. The risks of antepartum and postpartum hemorrhage were 21.4% and 14.3%, respectively.
  
  
  CONCLUSIONS
  Having a placental edge more than 10 mm from the internal os, measured by transvaginal sonography near term, justifies allowing a trial of labour and carries a low risk of subsequent obstetrical hemorrhage.
authors.affiliation: Women's Hospital, Department of Obstetrics, Gynaecology and Reproductive Sciences, University of Manitoba, Winnipeg MB; Women's Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Al Wadi
authors.affiliation: Women's Hospital, Department of Obstetrics, Gynaecology and Reproductive Sciences, University of Manitoba, Winnipeg MB.
authors.forename: Carol
authors.initials: C
authors.lastname: Schneider
authors.affiliation: Women's Hospital, Department of Obstetrics, Gynaecology and Reproductive Sciences, University of Manitoba, Winnipeg MB.
authors.forename: Craig
authors.initials: C
authors.lastname: Burym
authors.affiliation: Women's Hospital, Department of Obstetrics, Gynaecology and Reproductive Sciences, University of Manitoba, Winnipeg MB.
authors.forename: Gregory
authors.initials: G
authors.lastname: Reid
authors.affiliation: Women's Hospital, Department of Obstetrics, Gynaecology and Reproductive Sciences, University of Manitoba, Winnipeg MB.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hunt
authors.affiliation: Women's Hospital, Department of Obstetrics, Gynaecology and Reproductive Sciences, University of Manitoba, Winnipeg MB.
authors.forename: Savas
authors.initials: S
authors.lastname: Menticoglou
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D010920:Placenta / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D014463:Ultrasonography
keywords: Caesarean section; low-lying placenta; placenta previa; transvaginal sonography; trial of labour