DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20203293

A comparative study of obstetrics outcome of placenta previa in scarred versus unscarred uterus at tertiary Hospital, Kathmandu, Nepal

Rakshya Upreti, Amit Rauniyar, Sumit Rauniyar, Shaheen N. Ansari, Madan Khadka

Abstract


Background: Placenta previa is an obstetric life-threatening condition with several maternal and fetal complications. The objective of this study is to compare the maternal and fetal outcome of placenta previa in scarred and unscarred uterus.

Methods: A retrospective case control study was carried out on 85 cases of placenta previa in the department of obstetrics and gynecology, Paropakar Maternity and Womens Hospital (PMWH) Kathmandu from April 2019 to May 2020 of which 46 had scarred uterus and 39 cases had unscarred uterus.

Results: Sixty-one of patients were less than 30 years of age, 62% presented with gestational age 28 to 37 weeks and 67% had parity between 1 to 5. Frequency of placenta previa in scarred uterus was 54% and that in unscarred uterus was 46%. Eighty percent cases with scarred uterus had anterior placenta compared to 33% of cases of unscarred uterus with p value of 0.009. 42% had grade 4 placenta previa on ultrasonography. 45 percent of patient with scarred uterus had PPH compared to 23% in unscarred group with p value of 0.03. Malpresentation was found in 7 cases in scarred group and in one case in unscarred. Cesarean hysterectomy was performed in 6 cases in scarred category compared to 2 in unscarred. Low birth weight was present in 28 cases in scarred category compared to 15 cases in unscarred category with p value 0.03.

Conclusions: This study concluded that fetal and maternal outcome is adverse for cases of placenta previa with scarred uterus compared to unscarred uterus.


Keywords


Placenta previa, Postpartum hemorrhage, Scarred uterus

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References


Arulkumaran SS. Best practice in labour and delivery. 1st ed. Cambridge, United Kingdom; NewYork: Cambridge University Press; 2009: 141-145.

Faiz AS, Ananth CV. Etiology and risk factors for placenta previa: an overview and meta-analysis of observational studies. J Matern-Fetal Neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet. 2003(3):175-90.

Kanak L, Gita BB. Fetomaternal outcome in placenta preiva with and without previous cesarean section-a prospective study. J Dent Med Sci. 2017;16(7):30-5.

Rangaswamy M, Govindaraju K. Fetomaternal outcome in placenta previa - a retrospective study in teaching hospital. Int J Reprod Contracept Obstet Gynecol. 2017;5(9):3081-4.

Parvin Z, Das S, Naher L, Sarkar SK, Fatema K. Relation of placenta praevia with previous lower segment caesarean section (LUCS) in our clinical practice. Faridpur Med College J. 2017;12(2):75-7.

Ahmed SR, Aitallah A, Abdelghafar HM, Alsammani MA. Major placenta previa: rate, maternal and neonatal outcomes experience at a tertiary maternity hospital, Sohag, Egypt: a prospective study. J Clin Diagn Res. 2015;9(11):QC17-19.

Uzma S, Kiani BA, Khan FS. Frequency of placenta praevia with previous cesarean section. Ann Pak Inst Med Sci. 2015;11(4):202-5.

Dashe JS, McIntire DD, Ramus RM, Santos-Ramos R, Twickler DM. Persistence of placenta previa according to gestational age at ultrasound detection. Obstet Gynecol. 2002;99(5 Pt 1):692-7.

Mohamedsalih DY, Hameed NR, Faisal S. Effect of previous scar uterus and sit of placentation on early pregnancy on early pregnancy outcome in Iraq. Int J Adv Res Biol Sci. 2018;5(5):100-25.

Bashir A, Jadoon HN, Abbasi AU. Frequency of placenta previa in women with history of previous caesarean and normal vaginal deliveries. J Ayub Med Coll Abbottabad JAMC. 2012;24(3-4):151-3.

Lama S, Ranjit S. Study on maternal and immediate fetal outcome of placenta previa. Nepal J Obstet Gynaecol. 2016;22(2):24-7.

Kavitha B, Hota BM. Clinical study of placenta previa in scarred and unscarred uterus. J Dr. NTR University Health Sci. 2018;7(1):13.

UM, SR, SS. Placenta previa with history of previous caesarean delivery - an obstetrician’s nightmare. J Womans Reprod Health. 2017;1(4):33.

Senkoro EE, Mwanamsangu AH, Chuwa FS, Msuya SE, Mnali OP, Brown BG, et al. Frequency, risk factors, and adverse fetomaternal outcomes of placenta previa in Northern Tanzania. J Preg. Hindawi. 2017:e5936309.

Tahseen H, Tahira T, Hafiz S, Noreen Z. Placenta previa: a comparative study of obstetrics outcome in previously scarred and unscarred uterus at services hospital, Lahore. Pak J Med Health Sci. 2018;12(3):889-91.

Yadava P, Patel R, Mehta A. Placenta previa: risk factors, feto-maternal outcome and complications. Int J Reprod Contracept Obstet Gynecol. 2019;8:4842.

Majeed T, Waheed F, Mahmood Z, Saba K, Mahmood H, Bukhari MH. Frequency of placenta previa in previously scarred and non-scarred uterus. Pak J Med Sci. 2015;31(2):360-3.

Iqbal K, Abid R, Irfan R, Shaheen F. Comparison of fetomaternal outcome between scarred and unscarred uterus in placenta parevia cases. J Soc Obstet Gynaecol Pak. 2016;6(3):102-6.

Nair DB, Murukesan L, Menon S. The effect of previous obstetric interventions in the outcome of placenta previa. Int J Reprod Contracept Obstet Gynecol. 2017;6(11):4879-85.

Katke RD. Placenta previa: outcomes in scarred and unscarred uterus. Int J Reprod Contracept Obstet Gynecol. 2017;5(8):2728-32.

Shinde DV, Rachkonda DL. A study on maternal and neonatal outcomes in placenta previa in a tertiary level hospital in India. Int J Med Sci Clin Invent. 2015;2(12):1480-4.

Shrigiriwar M, Kesarwani S, Ramteke S. Feto-maternal outcome in placenta previa in scarred versus non-scarred uterus. Int J Sci Study. 2019;6(11):13-8.