Placenta Praevia at the University of Port Harcourt Teaching Hospital: a Five Year Retrospective Study

ABSTRACT

Placenta praevia is a major cause of obstetric haemorrhage commonly encountered in clinical practice in our environment. It is a life threatening condition both to the mother and her baby.To report the incidence of placenta praevia and describe its clinical presentation; associated risk factors and maternal and perinatal outcomes over a five year period at the University of Port Harcourt Teaching Hospital; Port Harcourt. A cross-sectional study design was employed in the review of hospital records of all women who had placenta praevia and had labour/delivery services at the University of Port Harcourt Teaching Hospital between January 2002 and December 2006. Simple frequencies; cross tabulations and summary statistics were computed and analysed using SPSS version 11 soft ware. Chi-square test of significance was used to compare proportions at P-value- 0.05.One hundred and forty cases of placenta praevia were observed over five years; giving a yearly rate of 28 cases; and an incidence rate of 1.0out of 13;870. One hundred and eighteen women (93.6) had vaginal bleeding out of which 96 (76.1) were painless vaginal bleeding. The mean time from onset of vaginal bleeding to presentation in hospital was 10.98(+ 13.08) hours. The commonly identified known risk factors were induced abortion (50) and previous caesarean section (25). The average time of hospitalization was 13.83 (+ 9.76) days. One hundred and fourteen cases (90.5) had diagnosis confirmed by ultrasound scan while twelve cases (9.5) had Examination Under Anaesthesia (EUA). The mean gestational age at delivery was 37.1 weeks. Caesarean delivery was performed for 101 (80) cases; while 25 (20) had vaginal delivery. There was one maternal death. Thirty two (25.3) babies had birth asphyxia. The perinatal mortality rate was 61.5/1;000 total births. Placenta praevia is still an important obstetric problem in our environment. Despite the fact that most of our women present late; the availability of blood transfusion services; adequate manpower; ultrasound scan and neonatal intensive care facilities have contributed immensely to improve maternal and fetal outcome of this condition in our centre