Perinatal mortality of placenta previa: a 1-year retrospective study

Abstract

Background: Antepartum haemorrhage is one of the important causes of perinatal mortality and morbidity in India. The increased risk of perinatal morbidity and mortality in placenta praevia is due to preterm birth, low birth weight, birth asphyxia and neonatal sepsis. This is a retrospective study done over a period of 5years to determine the incidence, demographic features, risk factors, obstetric management, maternal mortality and morbidity, and perinatal outcome in women presenting with placenta praevia.Methods: This was a retrospective study done at Nil Ratan Sircar Medical College and Hospital over a period of five years starting from January 2016 to December 2017. Antenatal women with more than 28 weeks of gestational age with a complaint of painless vaginal bleeding or those diagnosed as having placenta praevia on routine ultrasound examination were included in this study and hospitalised. Among them cases of placenta praevia were 21.Results: There were21 cases of placenta praevia registered amounting to 0.23% incidence. The various antenatal complications seen associated with placenta praevia were severe anaemia (14.28%), coexisting PIH (4.76%), IUD (4.76%), IUGR/Oligohydraminos (4.76%). All the patients in the study had undergone caesarean deliveries. Perinatal morbidity studied as percentage of new-borns requiring resuscitation followed by NICU admission was 33.3%. Among the delivered patients of placenta praevia incidence of perinatal mortality was 23.8%. Prematurity (42.85%) contributed to most cases of perinatal mortality, followed by RDS (14.28%) and asphyxia (14.28%).Conclusions: In this study placenta praevia is seen more commonly in 28-34 weeks of gestation and patients mainly presented with a bout of bleeding eventually had preterm deliveries. Although vaginal deliveries are appropriate in selected cases of placenta paevia liberal use of caesarean section in well-equipped hospitals with availability of blood transfusion services have helped to lower complications.

Maternal and Perinatal Outcomes in Placenta Previa: A Comprehensive Review of Evidence

“…Additionally, perinatal mortality rates are elevated in placenta previa, with one study reporting a rate of 81 per 1,000 births [ 3 ]. The heightened risk of neonatal morbidity and mortality stems from various factors, including preterm birth, low birth weight, birth asphyxia, and neonatal sepsis [ 28 ]. Prematurity notably contributes to perinatal mortality, with one study attributing 42.85% of perinatal mortality cases to prematurity [ 28 ].…”

“…The heightened risk of neonatal morbidity and mortality stems from various factors, including preterm birth, low birth weight, birth asphyxia, and neonatal sepsis [ 28 ]. Prematurity notably contributes to perinatal mortality, with one study attributing 42.85% of perinatal mortality cases to prematurity [ 28 ]. Furthermore, respiratory distress syndrome (RDS) and asphyxia also play significant roles in perinatal mortality associated with placenta previa [ 28 ].…”

“…Prematurity notably contributes to perinatal mortality, with one study attributing 42.85% of perinatal mortality cases to prematurity [ 28 ]. Furthermore, respiratory distress syndrome (RDS) and asphyxia also play significant roles in perinatal mortality associated with placenta previa [ 28 ]. The literature underscores the importance of a multidisciplinary approach in managing placenta previa and PAS disorders, with early identification of risk factors and strategic management being pivotal for improving maternal and fetal outcomes [ 28 ].…”

“…Furthermore, respiratory distress syndrome (RDS) and asphyxia also play significant roles in perinatal mortality associated with placenta previa [ 28 ]. The literature underscores the importance of a multidisciplinary approach in managing placenta previa and PAS disorders, with early identification of risk factors and strategic management being pivotal for improving maternal and fetal outcomes [ 28 ]. Conservative management should be considered for cases involving fertility desires and extensive disease due to surgical complexities [ 28 ].…”