Placenta previa: risk factors and maternal outcome - an eighteen months prospective study

Aims and Objectives: To evaluate demographic profile, various risk factors and maternal outcome in patients with placenta previa.
Material and Methods: The present study was done on prospective basis on 100 patients of placenta previa admitted in Department of Obstetrics and Gynaecology, Govt. Medical College and Rajindra Hospital, Patiala from 1st January 2013 to 30th June, 2014. Results: Mean age of patients was 26.39±3.5years. 83% were multigravida, 78% patients belonged to rural area and majority patients were unbooked (86%). Major group of unbooked cases (68%) belonged to rural areas, 78% belonged to low socio economic status and 35% of the patients were illiterate. 91% patients were diagnosed as placenta previa on ultrasonography and major group of patients (86%) were major degree placenta previa. Malpresentation were noted in 26% patients, 61% patients had emergency cesarean section. 69% patients required blood transfusion. 21% patients had history of caesarean section in previous deliveries. History of dilatation and curettage was present in 25% patients, placenta previa in previous pregnancy, twin gestation and history of myomectomy were seen in 1% patients. Maternal intraoperative complications noted were placenta accreta requiring cesarean hysterectomy (5%), haemorrhagic shock (8%), classical cesarean (1%), broad ligament hematoma (1%), bladder trauma (2%). Postoperative complications noted were postpartum haemmorrhage (14%), near missed cases (8%), ICU admissions (3%), wound infection (3%), wound gaping requiring resuturing (1%), puerperal pyrexia (3%) and prolonged stay in hospital (>9 days) in 62% patients. Maternal mortality was 1%.
Conclusion: Patient with anti partum haemorrhage should be considered as very high risk and timely management should be given at tertiary care hospital well-equipped and round the clock availability of blood and blood products. Family planning should be strongly emphasized and considering high perinatal mortality, neonatal care units should be besides labour ward.