Feto maternal outcome in placenta previa and morbidly adherent placenta
Keywords:Placenta previa, LSCS, PPH, GA
Background: Placenta forms the most important link between the developing foetus and the mother. The placenta's health is crucial for the foetus' proper growth and development. The outcome of pregnancy is changed when there is a change in the placental location or architecture for both the mother and the foetus. No matter the cause, placenta previa increases maternal and foetal risks by several times. Aim and objectives of current study are to investigate the incidence of placenta previa in hospital obstetric patients and the maternal and fetal outcome in cases of placenta previa.
Methods: 100 patients delivered in the Govt. Medical College, Kota with cases of placenta previa. Risk factors like Gestational age at the onset of bleeding, expectant management, gestational age at delivery and the mode of delivery. The birth weight and APGAR score of the newborn were observed.
Results: The risk of placenta previa is 3 time higher in multigravida than primigravida. 52% chances of placenta previa with male babies. Peak incidence of bleeding is noted around 34-36 weeks. 92% of placenta previa cases were delivered LSCS. PPH was main morbidity out of all morbidities. 55% of babies were less than 2.4 Kg. 44% were anterior, 38% posterior and rest 6% central placenta previa.
Conclusions: Placenta previa poses a serious risk to both the mother and the foetus, whether it is accidentally discovered by ultrasound or as a result of a clinical emergency like a haemorrhage in the mother. The best outcome can be achieved with an accurate diagnosis, prudent expectant management, blood transfusion as necessary, and prompt delivery.
Jauniaux ERM, Alfirevic Z, Bhide AG, Belfort MA, Burton GJ, Collins SL, et al. Placenta Praevia and Placenta Accreta:Diagnosis and Management:Green top Guideline No.27a. BJOG. 2019;126:1.
Balaya J, Bondarenko HD. Placenta accreta and the risk of adverse maternal and neonatal outcomes. J Perinat Med. 2013;41(2):141-9.
Farquhar CM, Li Z, Lensen S, McLintock C, Pollock W, Peek MJ, et al. Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: A case-control study. BMJ. 2017;7:10.
Cheng KK, Lee MM. Rising incidence of morbidly adherent placenta and its association with previous caesarean section: a 15-year analysis in a tertiary hospital in Hong Kong. Hong Kong Med J. 2015; 21(6):511-7.
Shruthi P, Mehta P, Rajeshwari KS. Maternal and fetal outcome of placenta previa in a tertiary care institute: a prospective two year study; 2016;3(3):274-8.
Peng ZH, Xiong Z, Zhao BS, Zhang GB, Song W, Tao LX, et al. Prophylactic abdominal arotic balloon occlusion: An effective method of controlling hemorrhage in patients with placenta previa or accrete. Exp ther Med. 2019;17(2):1492-6.
Ananth CV, Smulian JC, Vintzileos AM. The effect of placenta previa on neonatal mortality: a population-based study in the United States, 1989 through 1997. Am J Obstet Gynecol. 2003;188:1299-304.
Fishman A, Shira G, Stephen T, Bani M. Risk factors for preterm delivery with placenta previa. J Perinat Med. 2012;40(2):39-42.
Rao BK, Ratnam SS, Arulkumaran M. Obstetrics and Gynecology for Post graduate. 2nd ed. India: Jaypee publishers; 1999:1;78.
Hibbard BM, Koifman A, Levy A, Zaulan Y, Harlev A, Mazor M, et al. The clinical significance of bleeding during the second trimester of pregnancy. Arch Gynecol Obstet. 2008;278(1):47-51.
Erfani H, Kassir E, Fox KA, Clark SL, Karbasian N, Salmanian B, et al. Placenta previa without morbidly adherent placenta: comparison of characteristics and outcomes between planned and emergent deliveries in a tertiary center. J Matern Fetal Neonatal Med. 2019; 32(6):906-9.
Zlantnik MG, Cheng YW, Norton ME. et al. Placenta previa and the risk of preterm delivery. J Matern Fetal Neonatal Med. 2007;20(10):719-23.
Cheng KKN, Lee MMH. Rising incidence of morbidly adherent placenta and its association with previous caesarean section: A 15-year analysis in a tertiary hospital in Hong Kong. Hong Kong Med J. 2015;21(6): 511-7.
Wasim T, Bushra N, Riaz S, Iqbal HI. Fetomaternal outcome in patients with placenta previa. Pak J Med Sci. 2020;36(5):952-7.