Twelve years experience of placenta previa and accreta in KAUH Jeddah

ABSTRACT

To determine the incidence of placenta previa / accreta, risk factors, neonatal and maternal outcome. A retrospective study was carried out on all cases of placenta previa / accreta delivered in King Abdul Aziz University Hospital Jeddah between 1990-2001. 157 cases of placenta previa were reported among the 32,528 deliveries [0.48%], among these cases 13 patients [8.3%] had accreta as well. Placenta previa was more common in the age groups 25- < 40 years and the frequency increases with increased parity. Placenta previa was more common in those who had lower segment cesarean section compared to those having vaginal delivery [3.22% versus 0.07%]. It was also more common in those with scarred uterus compared to unscarred uterus [0.98% versus 0.42%]. Hysterectomy was needed in 6 patients 3.8% and hysterotomy in one patient [0.64%]. We reported five perinatal deaths and low apgar score [< 7 at S minutes] in 13 babies. Maternal and perinatal morbidity caused by placenta previa / accreta are still present today inspite of the skillful and qualified obstetricians, sufficient anethseiology personel and blood bank resources. This may be due to the phenomen of unlimited increase rate of multiple cesarean section [48.5%]