DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20181415

Maternal and fetal outcome of Placenta Previa at a tertiary centre in North Kerala, India

Mohammed Sidhiq C.

Abstract


Background: Placenta previa is defined as placenta that is implanted somewhere in the lower uterine segment either over or very near the internal cervical os. Placenta previa and coexistent accrete syndromes contribute substantively to maternal and perinatal morbidity and mortality.

Methods: This study was conducted in the Department of Obstetrics and Gynaecology during the period from June 2016 to May 2017 including antenatal patients of 24 weeks of gestation regardless of their parity. They would be selected from the same O.P day as that of case in a 1:4 case: control manner. Statistical analysis was done using SPSS version 16.0 for Windows.

Results: Age, booking status, Gestational age at delivery and gravidity was comparable between the two groups. The risk for placenta praevia was more among patients with a previous history of CS. Risk for antepartum bleeding was significantly higher among cases of placenta praevia. CS rate and proportion of patients who required blood transfusion was significantly high among cases. Intraoperative and postoperative complications were significantly higher among cases. There was no significant difference in neonatal death rate and NICU admission rate between the two groups.

Conclusions: Incidence of placenta previa is 0.78%. There is significant association with placenta previa and maternal morbidity, first trimester and second trimester bleeding increased blood transfusions, need for caesarean section, prolonged hospital stay, previous caesarean section, previous dilatation and curettage, placenta accreta, postoperative complications and NICU admission. Measures to reduce the primary caesarean section rate should be adopted.


Keywords


Antepartum hemorrhage, Maternal morbity, Placenta previa

Full Text:

PDF

References


Ananth CV, Demissie K, Smulian JC, Vintzileos AM. Placenta previa in singleton and twin births in the United States, 1989 through 1998: a comparison of risk factor profiles and associated conditions. Am J Obstet Gynecol. 2003;188(1):275-81.

Crane JM, Van den Hof MC, Dodds L, Armson BA, Liston R. Maternal complications with placenta previa. Am J Perinatol. 2000;17(2):101-5.

Crane JM, van den Hof MC, Dodds L, Armson BA, Liston R. Neonatal outcomes with placenta previa. Obstet Gynecol. 1999 177: 201-4.

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(5):1299-304.

Obstetrical hemorrhage. In: Cunningham FG, MacDonald PC, Grant NF, Leveno KJ, Gilstrap LC, Hankins GDV et al. eds. Williams Obstetrics 20th ed. Norwalk, Conn: Appleton and Lang 1997; 745-82.

Oppenheimer LW, Farine D, Ritchie JW, Lewinsky RM, Telford J, Fairbanks LA. What is a low-lying placenta? Am J Obstet Gynecol. 1991;165(41):1036-8.

Tuzović L, Djelmis J, Ilijić M. Obstetric risk factors associated with placenta previa development: case-control study. Croat Med J. 2003;44(6):728-33.

Sheiner E, Shoham-Vardi I, Hallak M, Hershkowitz R, Katz M, Mazor M. Placenta previa: obstetric risk factors and pregnancy outcome. J Matern Fetal Med. 2001;10(6):414-9.

Hung TH, Hsieh CC, Hsu JJ, Chiu TH, Lo LM, Hsieh TT. Risk factors for placenta previa in an Asian population. Int J Gynaecol Obstet. 2007;97(1):26-30.

Gurol-Urganci I, Cromwell DA, Edozien LC et al. Risk of placenta previa in second birth after first birth cesarean section: a population-based study and meta-analysis. BMC Pregnancy Childbirth. 2011;11(1): 95.

Usta IM, Hobeika EM, Abu Musa AA et al. Placenta previa-accreta: risk factors and complications. Am J Obstet Gynecol. 2005;193(3);1045-9.

Cieminski A1, Długołiecki F. Placenta previa accreta Ginekol Pol. 2004;75(12):919-25.

Farine D, Fox HE, Timor-Tritsch I. Vaginal ultrasound for ruling out placenta praevia. Case report. Br J Obstet Gynaecol. 1989;96(1):117-9.

Smith RS, Lauria MR, Comstock CH, Treadwell MC, Kirk JS, Lee W, Bottoms SF. Transvaginal ultrasonography for all placentas that appear to be low-lying or over the internal cervical os. Ultrasound Obstet Gynecol. 1997;9(1):22-4.