Résumé
Background: Placenta previa is one of the major causes for obstetric hemorrhagic morbidity and mortality with increasing incidence in recent times. This study aims at determining risk factors, maternal and fetal outcome associated with placenta previa.Methods: This was an observational, retrospective study conducted at a tertiary care hospital in Mumbai from May 2017 to March 2020. A total of 102 women with placenta previa during the study period were included, their case records critically analyzed to identify risk factors, maternal outcome in relation with blood transfusion required, ICU admission, obstetric hysterectomy and fetal outcome pertaining to prematurity, asphyxia and mortality.Results: A total of 102 patients were analyzed. Placenta previa was more common in >26 years of age, multipara (64.7%), with previous history of caesarean sections (21.5%) and previous curettage (11.7%), 44.2% babies born were preterm, 4.4% stillbirths and 8.5% neonatal deaths. Maternal complications like antepartum hemorrhage was seen in 58.8% patients and postpartum hemorrhage in 33.3%, blood transfusion was required in only 18 patients post operatively, bladder rent was seen in 3 patients and there was no maternal mortality. 44 patients required uterine artery ligation, Ashok Anand stitch was taken in 37 patients, uterus compression sutures in 10, obstetric hysterectomy in 7 patients and internal iliac artery ligation in 2 patients.Conclusions: Early identification of women at risk, obstetric preparedness and simple techniques like uterine artery ligation, Ashok Anand stitch and uterine compression sutures can help in effectively reducing need for multiple blood transfusions and morbidity.
Résumé
Background: morbidly adherent placenta has an increasing incidence over decades. The purpose of this study is to identify risk factors and etiology of placenta previa- accreta and percreta.Methods: A cross sectional observational study of patients with morbidly adherent placenta previa including placenta accreta and placenta percreta were studied over a period of three years from June 2017 to June 2019 in a tertiary care centre, Mumbai.Results: Cases showed a higher incidence in patients with previous cesarean delivery (CS), grandmultiparity, abortions without the history of check curettage and anterior/central placentae.Conclusions: History of uterine surgeries and previous cesarean are some important risk factors for accreta in placenta previa patients.
Résumé
Background: This study was carried out at a tertiary health centre with the aim of studying the effect of short interpregnancy interval on fetomaternal outcome. The maternal complications and fetal complications of short interpregnancy interval were analysed in comparison to normal interpregnancy interval.Methods: This is a case control study. 125 women with short interpregnancy interval seeking healthcare at tertiary health care centre were matched with 125 women with normal interpregnancy interval on the basis of demographic characteristics like age, height, weight and socio-economic status. These were included in the case control study.Results: Short interpregnancy interval is associated with increased risk of anemia, premature rupture of membranes (PROM), scar dehiscence and low birth weight whereas normal interpregnancy interval is associated with increased risk of PIH as compared to short interpregnancy interval.Conclusions: Short interpregnancy interval is associated with increased risk of anemia, PROM, scar dehiscence and low birth weight whereas normal interpregnancy interval is associated with increased risk of PIH.