MATERNAL AND PERINATAL OUTCOME IN PREGNANCIES COMPLICATED BY PLACENTA PREVIA

AIMS AND OBJECTIVES: To evaluate the maternal and perinatal outcome of pregnancies complicated with placenta previa at tertiary care centre and to evaluate the potential risk factors involved in pregnancies complicated with placenta previa at tertiary care Centre. METHOD: We carried out 2 year retrospective observational study during period from November 2009 to October 2011 Tertiary care hospital and medical college. ANC cases with history of bleeding per vaginum after 28 weeks attending ANC clinic and emergency ward were included in study with appropriate age parity matched controls with other complications like pregnancy induced hypertension, abruption placentae, multiple gestation were excluded. Demographic data, medical and surgical histories, all the events regarding maternal and perinatal mortality were recorded. Data was analysed by using appropriate software. RESULTS: 136 cases of placenta previa were analysed and found prevalence of placenta previa was 1.36%. During the present study 41.80% cases were booked and 58.20% cases were unbooked. Maximum number of cases in present study were in the age group of 18-24 years. Previous caesarean (57.49%) and previous abortion (42.53%) found important risk factors. 41.04% cases were delivered at 33-36 weeks of gestation followed by 33.58% in 28-32 weeks of gestation. Expectant management was given to 37.32% of cases while 62.68% cases were managed on active basis. In present study maternal morbidity were postpartum hemorrhage (56.71%), sepsis (37.31%), urinary tract infection (5.22%), wound infection (5.22%), wound gape (4.47%), hysterectomy (2.23%), prolonged hospital stay >10 days (17.91%). There were two (1.49%) maternal mortality in present study. Maximum number of infants i.e. 58.20% had birth eight between 1.6 to 2.4kg. Out of this 16.41% were of 1.6-2kg and 41.79% comprised of 2.1-2.4 kg. 39.55% infant required NICU admission and 60.45% of cases were with mother. Perinatal mortality was 2.98%. This is attributable to NICU facilities available at tertiary care centre. CONCLUSION: Placenta previa complicating pregnancy is responsible for significant maternal and neonatal morbidity and mortality. Such a high risk pregnancy irrespective of fact whether the placenta previa is of major degree or minor degree managed at tertiary care centre. All cases of placenta previa presenting with bleeding per vaginum irrespective of gestational age should be managed at tertiary care centre where team of expert obstetrician, anaesthetist, neonatal and blood facilities are available.