Ante partum haemorrhage due to placenta-previa: an alarm to mother and foetus

ABSTRACT

Placenta previa is the major cause of antepartum haemorrhage. It is one of the known cause of foeto maternal mortality especially in the unbooked cases.Pregnant patients of 15-45 years age admitted through OPD/COD during three years from April 1996-1999 were included in the study.Diagnosis was made on the clinical grounds and confirmed by the ultrasonography. Risk factors and the out come was compared in booked and unbooked cases. Results concluded good prognosis in booked cases where problem was detected earlier and monitored vigilantly. In unbooked cases haemorrhage, infection, coexisting pathology and surgical complications caused maternal mortality while prematurity, hypoxia and malpresentation were associated with foetal mortality. In conclusion early diagnosis management and preventing the avoidable causes were suggested i.e., limiting the family to 3 by the age of 30 years and later use of contraceptive methods, admission of the pregnant patient with placenta previa at the gestational age of 34 weeks completed or earlier if any complication arises and this followed by the cesarean section at 37 completed weeks, especially in the cases of central placenta previa, previous cesarean section or coexisting pathology. Education about the antenatal care, health facility for foeto maternal health at hospitals is important, easy and rich availability of the blood for transfusion if required. Surgical facilities in cases with haemorrhage, Bed rest, avoiding trauma and long travelling in high risk cases especially in cases of placenta previa type 3 or 4