Analysis of maternal and fetal outcome of placenta previa

Abstract

Background: Placenta previa, a condition in which the placenta is inserted into the lower uterine segment, causes bleeding and is a major risk factor for obstetric haemorrhage. Early diagnosis, blood transfusion, and multidisciplinary treatment can reduce maternal mortality rates. This study aimed to investigate the clinical aspects of the course of pregnancy, risk factors, maternal and foetal outcomes of patients admitted with the clinical features of placenta previa, and maternal and perinatal complications.

Methods: This cross-sectional study included 170 patients with placenta previa admitted to the Tirunelveli Government Medical College between September 2019 and September 2021. Patient details, obstetric history, and clinical examinations were recorded during admission. They underwent USG, MRI, and foetal and maternal examinations. The cases were managed based on placenta previa, gestational age, and conditions.

Results: Type 4 placenta previa, the most common type, accounted for 40% of cases, with bleeding per vagina being the primary complaint in 46% of cases. MRI was performed in 85% of patients, and emergency caesarean section was performed in 78%. Postpartum, 36% required hysterectomy due to haemorrhage. Babies had an average weight of 2.5-3 kg, with 30-32% having low birth weight. The maternal mortality was 1.18%, with 5% intrauterine and 4% neonatal deaths. Placenta previa was more common in women aged 25-29 (38%) and associated with previous caesarean sections (40%). Foetal malpresentation was higher (28%) in cases of placenta previa, mostly breech (49%).

Conclusion: This study suggested that advancing maternal age, gravidity, parity, previous abortion, and caesarean section were increased risk factors for placenta previa.