Placenta previa major degree; obstetrical risk factors and maternal outcome

ABSTRACT

Placenta previa is implemented in lower uterine segment. Haemorrhage is likely to happen on digital examination. Causes of placenta previa have strong association with advanced maternal age multiparity, multiple gestation and previous caesarean section, spontaneous and induced miscarriage, smoking and cocaine abuse. Maternal and fetal well being was assessed by general physical examination. Management plan was according to diagnosis. Descriptive study. This study was conducted at Gynae Unit 3, Nishtar Medical College / Hospital, Multan from. Fifty patients who were booked and fifty were un-booked and their ages were between 20-39 years and they were diagnosed case of major degree placenta previa were taken. Risk factors and maternal outcome was seen through Performa. Total number of deliveries during study period was 4826, 98 patients 2% presented with APH and 50 [51%] patients were diagnosed having major degree placenta previa. Different maternal complications seen during Antenatal, Inter operative and Post-operative period. Operative complications were bladder injury in 1 [2%] cases, DVT in 1 [2%] cases, 2 [4%] cases of pulmonary embolism. Four patients had PPH, one required caesarean hysterectomy, three settled with conservative measures like syntocinon and PGF[2] alpha. There was a significant trend between increase in incidences of placenta previa and number of C-sections. The study has clearly identified the association between increase maternal age and incidence of placenta previa with increasing number of C-section. Clinical judgement and skill in the performance of C-section D and C and other forms of uterine invasive techniques may help to keep subsequent incidence at a reasonably low rate. Family planning should also be emphasized as a strategy towards reduction of parity and C-section rate and incidence of placenta previa