A prospective study of fetomaternal outcome in cases of placenta previa
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20191189Keywords:
Antepartum haemorrhage, Bleeding per vagina, Low lying, Placenta previaAbstract
Background: The incidence of placenta previa ranges from 0.5-1% amongst hospital deliveries. Placenta previa is major cause of antepartum haemorrhage and is potentially devastating complication. Obstetric haemorrhage is most common cause for maternal and perinatal morbidity and mortality in India. This study aimed to determine frequency, type of placenta previa, risk factors and adverse fetomaternal outcomes of placenta previa.
Methods: This was a prospective study carried out in Department of Obstetrics and Gynaecology, Government Medical College and Sir-T hospital, Bhavnagar from July 2007 to July 2009 to analyze fetomaternal outcome in cases of placenta previa. All patients of placenta previa with gestational age > 28 weeks up to full term were included in the study. All cases were confirmed by Ultrasound examination. All cases were carefully analyzed to find out the incidence, type of placenta previa, its clinical presentation and its outcome in relation to mode of delivery, birth weight, maternal and perinatal morbidity.
Results: There was total 50 cases of placenta previa out of 5636 deliveries. The prevalence of placenta previa was 0.88% and was more commonly present among multiparous women (82%). Most common type was type IV placenta previa in 23 (46%) cases followed by type III in 11 (22%) cases. Out of 50 cases, 06 (12%) cases had atonic PPH and 02 (04%) cases underwent peripartum hysterectomy. Most common predisposing factors were age >35 years (04%), multiparity (50%), previous cesarean section (16%) and previous history of abortion (12%). All cases of perinatal mortality were between 28 to 30 weeks weighing between 1-1.5 kg. There was no maternal mortality in this study.
Conclusions: Managing a case of placenta previa during pregnancy poses a great challenge to every obstetrician in present day obstetrics due to its increased risk of maternal and perinatal complications.
References
Williams obstetrics study guide. Hoffman, Barbara L; Horsager, Robyn; Roberts, Scott, (Professor of Obstetrics and Gynecology). 24th edition. New York: McGraw-Hill Education, 2014.
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.
Sekiguchi A, Nakai A, Kawabata I, Hayashi M, Takeshita T. Type and location of placenta previa affect preterm delivery risk related to antepartum hemorrhage. Int J Med Sci. 2013; 0(12):1683-8.
Faiz AS, Ananth CV. Etiology and risk factors for placenta previa: An overview and metaanalysis of observational studies. J Maternal Fetal Neonatal Med.2003;13(3):175-90.
Jang DG, We JS, Shin JU, Choi YJ, Ko HS. Maternal outcomes according to placental position in placenta previa. Int J Med Sci. 2011; 8(5):439-44.
Nankali A, Keshavarzi F, Shajari A, Daeichin S. Frequency of placenta previa and maternal morbidity associated with previous cesarean delivery. Open J Obstet Gynecol. 2014;4(14):903.
Das B. Antepartum haemorrhage in three decades. J Obstet Gynecol India. 1975;25:636-7.
Silver R, Depp R, Sabbagha RE, Dooley SL, Socol ML, Tamura RK. Placenta previa: aggressive expectant management. Am J Obstet Gynecol. 1984;150(1):15-22.
Bhaskar RK, Manorama S, Maternal prognosis in placenta previa. J Obstet Gynecol India. 1975;25:642-46.
Bhatt AD, Meena A, Desai MR, Maternal and perinatal outcome in cases of placenta previa. Int J of Sci and Res (IJSR). 2014;3(1):299-301.