Major degree placenta praevia; frequency of risk factors, complications and perinatal outcome

Placenta praevia is a major cause of maternal and fetal morbidity and mortality. It is a major cause of obstetrical haemorrhage in second and third trimester of pregnancy. Placenta pravia usually presents with antepartum haemorrhge and as a source of maternal morbidity, it remained a significant cause of hospitalization and caesarean section. The study was carried out to see the frequency of risk factors, maternal complications and perinatal outcome in major degree placenta praevia. I]. To Find out major risk factors and maternal complications in major degree placenta praevia. II]. Know perinatal outcome in major degree placenta praevia. It is a descriptive study. Patients were selected by simple random sampling techniques. The study was carried out at Gynae Unit-I, Allied Hospital, Faisalabad from March 2005 to February, 2006. Seventy five patients selected for the study after fulfilling the inclusion criteria for major degree placenta praevia. The included patients were examined thoroughly and relevant information was recorded into proforma giving detailed history, clinical examination, investigation and management. In this descriptive study, total 75 patients were included as a diagnosed a case of major degree placenta praeiva. There were 15 patients presented asymptomatically and the rest of 60 patients were symptomatic. Out of 75 patients, majority of the patients belonged to the age group of 24-35 years. The mean age was 31.5 years. 2 patients expired due to massive PPH, 10 patients underwent obstetrical hysterectomy. In these 10 patients, 3 patients had placenta accrete, 1 patient had placenta increta and 2 had placenta percreta. Predisposing factors were previous gynaecological operations in 15 patients, history of previous C-section in 14 patients, history of previous placenta praevia 8 patients, advanced maternal age 5 patients and history of myomectomy in 3 patients. The remaining 39 patients had no predisposing risk factor. The mean gestational age was 36 weeks. 57 babies were delivered by emergency C-section and the remaining 18 patients underwent elective C-section. Live birth account was 66. Out of 75 babies, 9 babies were IUD, 48 were preterm, 17 were IUGR, 25 babies were having RDS and 3 babies were abnormal congenitally and 13 perinatal deaths occurred. Significant improvement in the neonatal care should be achieved in our tertiary environment to improve expected survival rate together with a reduction in overall morbidity for the premature new born

Abdominal pregnancy; a diagnostic dilema

Abdominal pregnancy is a rare complication with maternal and even higher perinatal mortality. To alert physicians and sonologists about features of abdominal pregnancy. To promote awareness about this potentially lethal condition. Observational case series. 2000 to 2007. Department of Gynecology and Obstetrics, Allied Hospital, Faisalabad. This study was conducted at department of Gynecology and Obstetrics, Allied Hospital, Faisalabad. Eight cases were done during the period 2000 to 2007. There demographic features including age, gestational age, ultrasound findings, operative findings and outcome were noticed. The mean age was 30.125 years [range 23-38]. The recorded mean gestational age was 20.62 [range 10-37 wks]. Out of 8 cases, 6 patients are more than 25 years age. Four patients [50%] were primi gravida. Maximum parity was of 3. Our 50% of patients were having either one or two abortions. The abdominal pregnancy presents in variable fashion with acute abdominal pain [100%], fainting attacks [25%], shock [25%] and rarely with PIH, fetal distress and loss of fetal movements. Abdominal ultrasound was helpful in diagnosis but not conclusive always. The fetal diagnosis was confirmed per operatively. On laparotomy the placenta was attached to different parts of abdomen as following. Abdominal pregnancy is potentially fetal for mother and fetus. The maternal mortality is 12.5% [1/8]. The fetus had 100% Mortality [8/8]. Abdominal pregnancy is a rare occurrence but is challenging diagnostically and therapeutically. Awareness of this condition is very important in reducing the associated morbidity and mortality