Placenta Previa Management Strategies to Reduce Maternal Mortality: A Systematic Review

Placenta previa is one of the leading causes of antepartum hemorrhage, significantly contributing to maternal mortality worldwide. Despite advancements in diagnostic and surgical technologies, placenta previa remains a serious clinical challenge, particularly in developing countries.Objective: To systematically analyze effective placenta previa management strategies in reducing maternal mortality based on current scientific evidence.Methods: A systematic review following PRISMA 2020 guidelines. Literature searches were conducted in PubMed/MEDLINE, Cochrane Library, CINAHL, and Scopus for the period 2016-2024. Inclusion criteria included studies on placenta previa, maternal mortality, and management strategies. Two independent reviewers performed article selection and data extraction.Results: Of 3,847 identified articles, 24 studies met the inclusion criteria (total 42,680 cases). Five main strategies were identified: (1) early prenatal diagnosis via transvaginal ultrasound, (2) conservative management in asymptomatic cases, (3) planned cesarean section at 36-37 weeks, (4) innovative surgical hemostasis techniques, and (5) perioperative massive hemorrhage management. This combination of strategies has been proven to reduce maternal mortality by 60-75% Conclusion: Comprehensive multidisciplinary management, involving early detection, thorough operative preparation, and aggressive hemorrhage management, has been proven to significantly reduce maternal mortality due to placenta previa.