Placenta Praevia at Usmanu Danfodiyo University Teaching Hospital; Sokoto: A 5-Year Review

Background : Placenta praevia is one of the most acute life-threatening obstetric emergencies. Its prompt management has been advocated to prevent associated morbidity and mortality. This study determines the incidence; risk factors; presentation; and maternal/fetal morbidity and mortality associated with placenta praevia in Usmanu Danfodiyo University Teaching Hospital; Sokoto. Materials and Methods : In this retrospective study; case notes of patients' that had placenta praevia from January 1; 2003 to December 31; 2007 were retrieved. Relevant data were extracted and analyzed using the Epi-info Version 3.5.1 statistical package. Results : The incidence of placenta praevia was 0.84. Grand multiparous women (50.0) were more affected than multiparous women (42.7). Majority (46.9) presented with vaginal bleeding after 28 weeks of gestation. The Major type of placenta paevia (77.1) occurred more than the Minor variety (22.9). The most common risk factor was previous abortion (18.75) while anemia (7.3while anemia (7.3) was the most common complication.) were delivered by Caesarean section. There was one (1.0) maternal mortality and 12 (12.5) perinatal deaths. Conclusions : Placenta praevia has a low incidence in the study population; is mainly of the Major type with identifiable risk factors and occur mainly in the 21-30 years age group and multiparous women. The major modes of presentations are vaginal bleeding and threatened abortion. Though maternal mortality is low perinatal mortality is high

Placenta previa and correlation with scarred uterus

Placenta previa refers to placenta that is situated wholly or partially in the lower uterine segment. Placenta previa is an obstetric complication that may cause serious morbidity and mortality to both fetus and mother. To determine the frequency of placenta previa among patients with scarred and unscarred uterus. To list the complications associated with placenta previa in patients with scarred and unscarred uterus. Cross sectional descriptive study for six months from 25.08.05 to 24.02.06. It was carried out in the department of obstetrics and gynaecology, Jinnah Hospital, Lahore. Total 50 women having placenta previa were enrolled. The frequency of placenta previa in scarred and unscarred uterus and its complications were studied. The study showed that out of 50 cases of placenta previa, 44% of the women were more than 30 years of age and 76% of the women were in 3rd. and higher gravida group. 44% of the women had uterine scar. There was not significant difference in the complications associated with placenta previa in scarred or unscarred uterus except for morbidly adherent placenta, which was seen in 72.73% of cases having scarred uterus as compared to 27.27% of cases having unscarred uterus. The clinical outcomes of placenta previa are highly variable and cannot be predicted confidently from antenatal events. Nonetheless, in the majority of cases without bleeding, outpatient management would appear safe and appropriate irrespective of the degree of placenta previa

Effect of placenta previa on fetal and maternal morbidity/mortality

To see the effect of placenta previa on fetal and maternal mortality/ morbidity. This was a case series study. Study was conducted in Gynecology unit BV Hospital Bahawalpur during year 2000 to 2003. All the patients presenting with or with out painless bleeding in antenatal clinic and proved to be due placenta previa were included in the study. Patients presenting with pain less bleeding in the antenatal clinic due to other reasons were excluded from the study. In all the patients' history along with the risk factors clinical and sonography finding, any intervention needed and final out come was recorded. SPSS was used for data collection and analysis. Total 50 patients were studied Out of these 84% of patients were symptomatic a t admission the symptoms found were Bleeding, shock and Pain. Strong associations o f risk factors like Age, Parity, ERCP, Smoking and previous C. Section was found in our study. Severe hemorrhage, prematurity, stillbirths and ENND was associated with Placenta Previa. Placenta previa is not an uncommon but underestimated, under reported and preventable condition. Prevention is possible in case of Known risk factors. Early diagnosis is necessary as the delay in some cases may end up in disaster