Frequency, Risk Factors, and Adverse Fetomaternal Outcomes of Placenta Previa in Northern Tanzania

Abstract

Background and Objective. Placenta previa (PP) is a potential risk factor for obstetric hemorrhage, which is a major cause of fetomaternal morbidity and mortality in developing countries. This study aimed to determine frequency, risk factors, and adverse fetomaternal outcomes of placenta previa in Northern Tanzania. Methodology. A retrospective cohort study was conducted using maternally-linked data from Kilimanjaro Christian Medical Centre birth registry spanning 2000 to 2015. All women who gave birth to singleton infants were studied. Adjusted odds ratios (ORs) with 95% confidence intervals for risk factors and adverse fetomaternal outcomes associated with PP were estimated in multivariable logistic regression models. Result. A total of 47,686 singleton deliveries were analyzed. Of these, the frequency of PP was 0.6%. Notable significant risk factors for PP included gynecological diseases, alcohol consumption during pregnancy, malpresentation, and gravidity ≥5. Adverse maternal outcomes were postpartum haemorrhage, antepartum haemorrhage, and Caesarean delivery. PP increased odds of fetal Malpresentation and early neonatal death. Conclusion. The prevalence of PP was comparable to that found in past research. Multiple independent risk factors were identified. PP was found to have associations with several adverse fetomaternal outcomes. Early identification of women at risk of PP may help clinicians prevent such complications.

Placenta Previa: Factors Associated and Prognosis in The Maternity Ward of Borgou UHC

“…In fact, in this study, multiparity and multigestity are associated with PP. The same observation is made by other authors in Iran and Tanzania [5,9]. According to the pathogenicity, the increased risk of placenta previa in multigravida women could be explained by the degenerative change in the uterine vascular system, leading to the drop in the placenta infusion responsible…”

“…None case of hysterectomy has been noted in our study. The lethality of PP at 1.6% is similar to the one found by N'guessan et al in Ivory Coast [4], whereas in developed countries, no maternal death due to PP is recorded [9,12,13]. That difference is due to poor anticipation in management of obstetrical emergencies in developing countries and particularly in Benin.…”

Implications of placenta previa on pregnancy outcome: A prospective study

“…Results are comparable to a study conducted by Anand et al 21 Similarly in a study done by Elizabeth et al in northern Tanzania showed caesarean section rate of 73.3%. 22 Placenta previa is associated with adverse pregnancy outcomes like increased risk of hemorrhagic shock, antepartum and postpartum hemorrhage, MROP, adjacent organ injury, peripartum hysterectomy, blood transfusion, prolonged hospital stay, and caesarean section .In our study, out of 262 women 40.3% had one or multiple complications. These findings are consistent with previous studies.…”

Maternal obesity and intrapartum obstetric complications among pregnant women: Retrospective cohort analysis from medical birth registry in Northern Tanzania

“…Information used in this analysis (date of first ANC visit, body weight, and height and date of last menstrual period) are drawn from ANC cards, and information on labour and delivery (mother's weight at admission, date and time of delivery, gestational age, plurality, and mode of delivery) comes from medical registry database. The details of data collection methods and tools have been described elsewhere . In summary, the data entered in the registry‐included parents' socio‐demographic characteristics, maternal health before and during the current pregnancy, complications during labour and delivery, and regarding the mother's previous pregnancies.…”