Impact of placenta praevia on obstetric outcome

Neelam Meena, Anupama Dave, Shivraj Meena, Asha Meena, Ankita Shrivastava

Abstract


Background: Placenta praevia is the implantation of the placenta partially or totally in the lesser segment of the uterus. The blood loss is generally mild and frequent but at times can be enormous and life threatening. The frequency of placenta praevia is 3-5 per 1000 pregnancies thought out the world and is still increasing for the reason that of growing caesarean section rates.2 The present study was carried out to asses impact of placenta praevia on obstetric outcome at our setup.

Methods: This was case control study that was conducted at department of gynaecology and obstetrics, M Y hospital, M G M medical college, Indore from Sep 2011 to Feb 2013. A predesigned proforma was used to collect the study variables.  

Results: The incidence of placenta previa was 0.76 %. Maximum patients belonged to age group of 21-30 years (70.43%) and in gravidae >2 (35.65%). In this study 22.6% patients of PPH, 36.52% of perpueral sepsis, 1.75% of UTI, 4.35% of ARF, 5.22% of wound infection, 1.74% of DIC and 5.22% patients of placenta accrete. Caesarean hysterectomy and uterine artery ligation were done in 6.08% and 13.04% patients respectively. Hysterectomy was done in 4 patients belonging to anterior PP and 3 patients in posterior PP group. Major placenta praevia was present in 47.82% patients. 6% patients present in hospital with gestational age <28 weeks. Low birth weight (<2.5 kg) baby was 65.21%. 2.86% patient of APH, 0.76% of PP, 1.40% of AP and 0.70% of UC.

Conclusions: It was concluded that increased maternal age and parity, history of previous caesarean section are identified risk factors which are same as reported in western literature. Sonographic determination of the placental position where its location be-Neath the uterine incision is very important to predict maternal outcomes in placenta praevia patients, and such cases, close attention should be paid for massive haemorrhage.


Keywords


Placenta praevia, Caesarean, Hysterectomy

Full Text:

PDF

References


Kiondo P, Wandabwa J, Doyle P. Risk factors for placenta praevia presenting with severe vaginal bleeding in Mulago hospital, Kampala, Uganda. Afr Health Sci. 2008 Mar;8(1):44-9.

Madan I, Romero R, Kusanovic JP, Mittal P, Chaiworapongsa T, Dong Z, et al. The frequency and clinical significance of intraamniotic infection and/or inflammation in women with placenta praevia and vaginal bleeding: an unexpected observation. J Perinat Med. 2010 May;38(3):275-9.

Boyle RK, Waters BA, O’Rourke PK. Blood transfusion for caesarean delivery complicated by placenta praevia. Aust N Z J Obstet Gynaecol. 2009 Dec;49(6):627-30.

Sinha P, Kuruba N. Ante-partum haemorrhage: an update. J Obstet Gynaecol. 2008;28:377-81.

Bahar A, Abusham A, Eskandar M, Sobande A, Alsunaidi M. Risk factors and pregnancy outcome in different types of placenta praevia. J Obstet Gynaecol Can. 2009;31(2):126-31.

Tai-Ho Hung, Ching-Chang Hsieh, Jenn-Jeih Hsu. Risk factors for placenta praevia in an Asian population. Int J Gynaecol Obstet. 2007;97:26-30.

Rabia Raheel, Rumina Tabassum, Ambreen Bhutto, Haris Riaz, Raheela Hanif. Fetal out come in cases of placenta praevia: a retrospective study. Med Channel. 2010 Jan;16(2):256-9.

Farkhunda Khursheed, Fouzia Shaikh, Chandra Madhu Das, Raheela Bilal Sheikh. Placenta praevia: an analysis of risk factors. Med Channel. 2010 Jul;16(3):417.

Nyango DD, Mutihir JT, Kigbu JH. Risk factors for placenta praevia in Jos, north central Nigeria. Niger J Med. 2010 Jan-Mar;19(1):46-9.

Surraya Halimi. Association of placenta praevia with multiparity and previous cesarean section. J Postgrad Med Inst. 2011;25(02):139-42.

Shabnam Naz, Rehana Parveen, Afshan Bhatti. Major placenta praevia: a true obstetric emergency. Med Channel. 2009 Jul-Sep;15(3):74-7.

Dong Gyu Jang, Ji Sun We, Jae Un Shin, Yun Jin Choi, Hyun Sun Ko, In Yang Park, et al. Maternal outcomes according to placental position in placental praevia. Int J Med Sci. 2011;8(5):439-44.

Wen S, Demissie K, Liu S, Marcoux S, Kramer MS. Placenta praevia and male sex at birth: results from a population-based study. Paediatr Perinat Epidemiol. 2000 Oct;14(4):300-11.

A. Ozgur Yeniel, A. Mete Ergenoglu, Ismail Mete Itil, Niyazi Askar, Reci Meseri. Effect of placenta praevia on fetal growth restriction and stillbirth. Arch Gynaecol Obstet. 2012 Aug;286(2):295-8.