Asymptomatic Complete Placenta Previa: A Case Report and Review of Literature

We present a case of a stable and asymptomatic complete placenta previa for all the duration of pregnancy in a 40-year-old woman, treated with an elective cesarean section at 37 weeks of gestational age. Placenta previa is a condition derived from an abnormal implantation of the embryos in the lower uterine segment. Risk factors for the development of placenta previa include prior cesarean delivery, pregnancy termination, intrauterine surgery, smoking, multi-fetal gestation, increasing parity, maternal age and the rising rates of cesarean section. Usually complete placenta previa becomes symptomatic in third trimester of gestational age and it is associated with adverse consequences for both mother and children, such as intra-uterine growth restriction, preterm birth, antenatal and intra-partum hemorrhage, maternal blood transfusion and emergency hysterectomy. In this article we performed a review the international literature of the last twenty years of similar cases, emphasizing on the aspects of the management and time of delivery in patient with placenta previa, and in particular we focus on the management of stable and asymptomatic cases. On the basis of our experience, the risks for both mother and fetus and the results of the literature, we conclude that in presence of a stable and asymptomatic complete placenta previa an early term birth (ETB) at 37 weeks of gestational age, rather than a late preterm birth (LPTB) between 34-37 weeks, is a more appropriate time of delivery, and it is associated to a better prognosis for both mother and child.