DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20194375

A prospective study of foetomaternal outcome in placenta praevia

Somika Kaul, Bijal Rami

Abstract


Background: Placenta praevia is one of the serious obstetric problems with far reaching effects and a major cause of antepartum haemorrhage. The aim of the study was to evaluate the foetomaternal outcome of pregnancies with placenta praevia.

Methods: The present study was a prospective case control study conducted in the Department of Obstetrics and Gynaecology, Lal Ded Hospital, Srinagar from August 2009 to October 2010.

Results: Among the 100 cases of placenta praevia studied bleeding per vaginum was the most common presenting symptom. Major placenta praevia was more common (53%) than minor placenta praevia. 43% of the cases of placenta praevia delivered before 37 completed weeks as compared to only 6% in the control group. All cases of placenta praevia delivered by caesarean section. Maternal morbidity in terms of postpartum haemorrhage (32%), intraoperative bowel and bladder injury (2%) and intensive care unit admission (1%) was more in cases of placenta praevia. Foetal complications in terms of neonatal intensive care unit admission (19%), neonatal death (10%) and stillbirth (5%) were more in pregnancies with placenta praevia as compared to controls. 48% of patients with placenta praevia required transfusion of blood and blood products as compared to 4.5% among controls.

Conclusions: There is a significant increase in maternal morbidity in pregnancies complicated with placenta praevia. Also, there is a higher incidence of foetal complications and neonatal death. Managing a case of placenta praevia is a challenge in present day obstetrics and it creates a huge burden on the health care system.


Keywords


Antepartum haemorrhage, Caesarean section, Foetal morbidity, Maternal morbidity and mortality, Neonatal intensive care unit admission, Placenta praevia, Postoperative complications

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References


Royal College of Obstetricians and Gynaecologists. Antepartum Haemorrhage: Green top guidelines No. 63, 2011. Available at: rcog.org.uk/globalassets/documents/guidelines/gtg_63.pdf.

Sheikh F, Khokhar S. A study of antepartum haemorrhage: maternal and perinatal outcome. Med Chan. 2010;16:22.

Baskett TF. Edward Rigby (1747-1821) of Norwich and his essay on the uterine haemorrhage. J Royal Society Med. 2002;95(12):618-22.

Gupta B, Mishra, R. Antepartum Haemorrhage. In: Mishra R, eds. Ian Donald’s practical obstetric problems. 7th ed. Wolters Kluwer. 2014:315-38.

Jauniaux ERM, Alfirevic Z, Bhide AG, Belfort MA, Burton GJ, Collins SL, et al. Royal College of Obstetricians and Gynaecologist: Placenta Praevia and Placenta Accreta: Diagnosis and Management. Green-top Guideline No 27 a, 2018. Br J Obstet Gynaecol. 2018:e10.

Obstetrical Hemorrhage. In: Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. eds. Williams obstetrics. 24th ed. McGraw-Hill; 2014:780-828.

Saeed Z, Ikram M, Tazian S. Placenta praevia; etiology and fetomaternal outcome. Prof Med J. 2009;16(1):139-44.

Rangaswamy H, Govindaraju K. Fetomaternal outcome in placenta praevia- a retrospective study in teaching hospital. Int J Repro Contra Obstet Gynaecol. 2016;5(9):3081-4.

McShane PM, Heyl PS, Epstein MF. Maternal and perinatal morbidity resulting from placenta praevia. Obstet Gynecol. 1985;65(2):176-82.

Sarojini, Malini KV, Radhika. Placenta praevia and its effect on marenal health and fetal outcome. Int J Reprod Contracept Obstet Gynecol. 2016;5(10):3496-9.

Nasreen F. Incidence causes and outcome of placenta praevia. J Post Med Inst. 2016;17(1):99-104.

Saeed Z, Ikram M, Tazian S. Placenta praevia; etiology and fetomaternal outcome. Prof Med J. 2009;16(1):139-44.

Dhanalaxmi KR. Clinical features and course of pregnancy in placenta praevia. Int J Reprod Contracept Obstet Gynecol. 2016;5(6):2000-4.

Kaur K, Kaur A, Garg R. Fetomaternal outcome in placenta praevia in scarred uterus. Int J Cur Res Med Sci. 2017;3(8):52-37.

Khirasaria DM, Nayak TC. A study of complications in cases of placenta praevia. Int J Contracept Obstet Gynecol. 2017;6(12):5503-7.

Sheiner E, Vardi IS, Hallak M. Placenta praevia: obstetric risk factors and pregnancy outcome. J Mat Foetal Med. 2001;10(6):414-9.