RESUMO
Background: Placenta previa is defined as placenta implanted partially or completely in the lower uterine segment. It contributes upto 30% of the cases the antepartum hemorrhage. This catastrophic complication not only poses a risk to the fetus but also endangers the mother’s life. The objective of the study was to determine the incidence and risk factors, obstetric management, maternal mortality and morbidity and perinatal outcome in women presenting with placenta previa.Methods: It is the prospective study of 50 cases carried out to study the maternal and perinatal outcome in cases of placenta previa in tertiary care hospital. This study included antenatal patient diagnosed as placenta previa by ultrasound >28 weeks to full term pregnancy. This data was compiled and analyzed for maternal and neonatal outcome.Results: In the present study, the incidence of placenta previa is 0.8% among which 42% of cases having age group of 25-29 years and 72% cases are multigravida. In this study 60% cases have major degree of placenta previa and 66% cases have previous history of caesarean section. Out of total cases 96% cases delivered by caesarean section and 4% had Normal delivery. NICU admission in the study is 28 babies i.e. 56%. There is no maternal mortality seen in the present study.Conclusions: Risk factors that increase the cases of placenta previa are multiparity, previous caesarean section, previous abortion. Placenta previa is major risk factor for adverse maternal and perinatal outcome. Good antenatal care, availability of emergency obstetrics services with senior obstetricians, blood bank facility, ICU care and NICU services can improve maternal and neonatal outcome in high risk cases.
RESUMO
The objective of the study was to find out the factors predicting outcome of trial of labour after previous caesarean delivery among women living in a developing country. A retrospective study of 149 cases of trial of Labour was conducted in women with a history of one prior caesarean section. Binary logistic regression was used to identify predictive factors. The adjusted odds ratios with 95% confidence intervals (95%CI) were used to indicate risk of failure of the trial of Labour when the factor was present. It was found that success rate of vaginal birth was 24.16%. Factors significantly predictive of success of trial of Labour were previous vaginal delivery (OR 18.4, 3.3 -329.6), baby weight < 3 kg (OR 33.3, 5.4-62.6) and 2nd stage of labour during previous LSCS (OR 2.1, 1-4.2). The study has shown that trial of labour can be attempted successfully, in women with previous caesarean delivery, with due consideration of maternal and foetal outcome. A prior history of vaginal delivery and baby weight < 3 kgs are the best predictor of success of trial of labour.