Frequency, risk factors and complications in pregnancies associated with placenta praevia

ABSTRACT

To evaluate the frequency of placenta praevia, risk factors, and complications, both maternal and fetal associated with placenta praevia. Cross-sectional and analytical study. Study was conducted in Department of Obstetrics and Gynaecology, Unit-1, Ghulam Muhammad Maher Medical College Hospital Sukkur from April 2010 to March 2012. In this study 75 cases of pregnancy beyond 24 weeks of gestation complicated by placenta praevia were included. Total number of deliveries was 5041 and patients presented with placenta praevia were 75. Patients with placenta praevia were 75 giving an incidence of 1.5%. Among 75 cases 67 cases were non-booked, 71 cases came in emergency, out of which 8 were referred cases. The gestational age at the time of admission was < 37 weeks in 57% of cases. The maximum number of patients 28 [37%] were between 30-40 years and above, while 44 [58.7%] women were multiparous, 41 [54.7%] cases had at least one or more gynaecol / obstet procedure before the presnt pregnancy. Incidence of placenta praevia was significantly high in patients with previous caesarean section [6%] than overall incidence of%. Regarding complication 7%] cases ended up in caesarean hysterectomy due to postpartum haemorrhage and morbid adherent placenta. Intra operative haemorrhage was found in 11 [14.7%] cases and 2-4 units of bloodlransfusion were required in 52 [69%] of cases. Pre-maturity was found commonest cause of perinatal mortality about 87%. The improvement in social, nutritional and educational status of women, provision of antenatal care and ultrasonography can help in diagnosing and in decreasing the complication rate. One should anticipate placenta praevia in all patients with previous caesarean section and ultrasound scan should be used for its diagnosis specially for placental localization in patients with history of previous caesarean section