Maternal and fetal outcome in placenta previa: our experience

Abstract

Background: Placenta previa contributes substantial maternal and neonatal morbidity including management challenges for obstetrician. This study was to evaluate the potential risks factors and feto-maternal, outcome in placenta previa. This study was done with the intent of developing insight into risk factors, clinical presentation, various interventions and management for overall improvement in maternal and fetal outcome in placenta previa.Methods: A prospective observational study, where 30 cases of placenta previa confirmed after 28 weeks POG, treated in a public sector tertiary care hospital from June 2016 to June 2018 were included. Authors analyzed the data to evaluate the potential risks factors and maternal and fetal outcome in placenta previa.Results: In this study, major contributing risk factors for placenta previa were associated with multiparity (76.7%), maternal age >30 in 50%, previous LSCS in 46.7%, repeated uterine procedure like suction evacuation/curretage. There was a high rate of maternal morbidity mainly due to haemorrhage. Perioperative uterine artery embolization (UAE) in 3 (10%), intra-operative procedures namely devascularization, internal iliac ligation in 66.6% cases, peripartum hysterectomy in 2 (6.66%) were done to control haemorrhage. Blood and blood products transfusion required in 26.7% of cases. Fetal morbidity included prematurity in 9 (33.3%), NICU admission in 11 (36.6%) majority of which included 8 (26.7%) babies of birth weight <2000 grams.Conclusions: Placenta previa contributes to significant maternal and neonatal morbidity. Multiparity, post LSCS pregnancy constitute major factor for placenta previa. Management requires high-risk obstetrical care with frequent antenatal visits. Serial ultrasonography in reported cases of low-lying placenta to mandatory exclude overdiagnosis or migration. All cases of placenta previa need to be managed in a higher centre facility of blood component therapy and neonatal intensive care unit. Prematurity and low birth weight remain a significant cause for neonatal morbidity.

Placenta Previa: Maternal and Fetal Outcome a Two Year Study

“…Totalnumbers of women delivered during the mentioned period were 8193, out which 210 pregnancies were complicated by placenta previa with incidence of 2.5%. The results were comparable Continue .......... with Maiti et al [3] with 2.2% incidence. In present study, majority of the women with placenta previa belonged to age group of 20-29 years with mean age of 26.45+-3.82yr.…”

“…Maiti et al [3] Maunica et al [4] Shruthi et al [9] Meenakshi et al [2] Present In the study done by Mcshane et al [12] with NICU admission 24%, neonatal deaths were lower in present study as recorded in study done byMeenakshi et al [2] ,Lavanya et al [13] was 6%. This may be due to timely and good antepartum and intrapartum care and good NICU care along with experienced neonatologist.…”

“…Maiti et al [3] Maunica et al [4] Shruthi et al [9] Santosh et al [10] Haripriya et al [11] Meenakshi et al [2] Present Study…”

“…The incidence of placenta previa is 0.4%-0.5% of all labor. [3] Risk factors for placenta previa includes previous uterine surgery, increased maternal age, multiparity, multifetal pregnancy, risk increasing with increasing number of cesarean section, for ≥ 3 cesarean deliveries chances of placenta previa being 37%, smoking, and history of abortions. [4] Availability of USG for early diagnosis of placenta previa, 24hr blood bank facilities, NICU care have improved the maternal and fetal outcome in placenta previa and has decreased the morbidity.…”

Maternal and perinatal outcome in placenta previa: a prospective observational study at a tertiary care hospital in Hanmakonda, Telangana, India

“…In present study, cesarean section rate was 90.4% (38 cases) which correlates with the study done by Maiti et al where the cesarean section rate was 93.4% and in study done by Rani et al 64% cases were delivered by cesarean section. 7,10 In present study, there has been a profound increase in cesarean section rate and improvement in perinatal and maternal outcome has been attributed to this.…”