A Study on Fetomaternal Outcome in Cases of Placenta Previa in a Tertiary Health Care Hospital (King George Hospital, Andhra Medical College, Visakhapatnam, Andhra Pradesh)
Keywords:Placenta previa, placenta accreta spectrum, caesarean hysterectomy.
Background: Incidence of placenta previa is 3-5per 1000 pregnancies. Placenta previa includes: (i) Low lying placenta i.e. when the lower edge of placenta is within 20mm distance from internal os. (ii) Placenta previa i.e. when placenta lies directly over the internal os. Objectives: The objective of the study was to determine the incidence, obstetric risk factors, obstetric management, maternal complications including mortality and fetal outcome in patients presenting with placenta previa. Methodology: A retrospective study was conducted over a period of 1 year in the department of Obstetrics and Gynaecology, tertiary health care centre at King George Hospital, Visakhapatnam, Andhra Pradesh. A total of 73 women with placenta previa were enrolled in this study with inclusion and exclusion criteria. A necessary information regarding history, clinical examination, investigations, maternal and fetal outcome were noted from existing medical records and were analysed. Results: About 0.9% of the deliveries were complicated with placenta previa among which 12.3% of women with >30years, 76.7% of women were multigravida, 32.9% of women with prior c-sections, 27.4% of women had prior abortions, 52% of women had major degree of placenta previa, 57.8% of women had preterm deliveries,100% of women delivered by caesarean delivery, 34.2% of women had PPH, 9.5% of cases had caesarean hysterectomy, 5.5% of cases had placenta accreta spectrum, 19% of cases had ICU admissions with 4% mortality and 34% of babies had ICU admissions. 31.5% had perinatal mortality. Conclusion: Placenta previa is one of the life threatening complication of pregnancy and its incidence is rising probably parallel to the rise in abortions and c-sections, about 60% of cases with placenta previa had prior surgical procedures. Meticulous management of placenta previa is important in order to reduce the untoward maternal and fetal complications.
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