Current placenta previa management and outcome in a rural tertiary care centre

Abstract

Background: The reported incidence for placenta previa averages 0.3% or 1 case in 300 to 400 deliveries. Multiparity, advanced maternal age, cigarette smoking, previous caesarean delivery, history of abortions or uterine surgical procedures are some of the risk factors contributing to the development of placenta previa. Massive obstetrical haemorrhage in placenta previa is associated with severe maternal morbidity and mortality. A significant number of mothers can be saved if right approach of management is followed in placenta previa.Methods: The present case study is a retrospective analysis carried out in a tertiary care centre to study the risk factors and maternal and perinatal outcome in cases of placenta previa. The study included antenatal patients diagnosed as placenta previa on sonography at or >26 weeks of pregnancy. Data was compiled and statistically analysed.Results: Incidence of Placenta Previa in our study was 0.54%. 73.2% patients had history of previous cesarean sections. 53.6% patients were referred from outside. 98.2% patients delivered by caesarean section. Obstetric hysterectomy was required in 3.5% of total cases. 10.7% cases required the ICU admission after delivery. There was no maternal mortality in the study group. The mean gestational age at delivery was 35±2.4weeks. The mean APGAR at 5 min was 9±2.2.Conclusions: Increasing rates of caesarean sections in present era indicate that incidence of Placenta Previa is expected to rise. Good antenatal care, availability of emergency obstetric services, infrastructure, blood bank facility, HDU and ICU care and NICU services can improve maternal and neonatal outcome.

Combined Internal Iliac Artery Ligation, Transverse B-Lynch Suture and Intrauterine Balloon to Control Bleeding from Placenta Accreta during Caesarean Delivery

“…Regarding demographic data, the present study goes in agreement with Sood et al (8) who reported that, majority of their patients were in the age group 20-35 years and the mean maternal age at development of placenta previa was 27.9±4.4 years. On the other side, Refaie et al (9) and Arduini et al (10) reported a mean maternal age of 33.59 ± 4.46 and 36.5 years respectively.…”

“…The present study agrees with Arduini et al (10) as they reported that, the mean gravidity and parity were 2.4 and 1.1 respectively and study done by Refaie et al (9) who found that the mean of gravidity was 4.02 ± 1.35 and the mean of parity was 2.74 ± 0.99. Sood et al (8) found that parity range from 2-4.…”

“…Clark et al (11) reported that, placenta previa in women without a history of delivery by CS was 0.26%, whereas it increased up to 0.65% in women with a history of delivery by one CS, reaching 10% after four or more CS. Sood et al (8) observes that 41patients had history of previous caesarean section accounting to 73.2%. History of previous one LSCS reported in 21.4 %, and previous two LSCS reported 47.4%.…”