Preterm Gebelerdeki̇ Semptomati̇k Placenta Previ̇a'Nin Yöneti̇mi̇ (original) (raw)
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Incidence of Placenta Previa, Management Andmaternal Outcome in Region of Taif. KSA
IOSR Journal of Dental and Medical Sciences, 2016
Introduction: Ante partum hemorrhage is defined as any vaginal bleeding from the 24 th week of gestation till delivery. The number of cases of placenta previa and placenta accrete are increasing with the increasing caesarean section rate.Ante-partum hemorrhage is an important cause of maternal and fetal morbidity and mortality, despite modern improvement in obstetric practice and transfusion service. Placenta previa has been well documented to be associated with adverse maternal outcomes as well as neonatal outcomes. The indication for emergency peripartum hysterectomy in recent years has been changed from traditional uterine atony to abnormal placental implantation. The incidenceplacenta previais on rise because of the increasing rate of caesarean section being performed, and a trend of child bearing at a later age among the women , with the sametime the dangerous complication placentaaccreta which is associated with placenta previa and prior caesarean deliveries has also been increased in frequency 16. Material and Methods: This retrospective study was designed to see the incidence of placenta previa , ultrasound finding, management and maternal outcome in women suffering from placenta previa .in region of Taifkingdom of Saudi Arabia. Result: In two year total no of deliveries was 17757 out of that 213 was cases of placenta previa that makes the 1.19 % of placenta previa out of total deliveries .Out of 5498 L.S.C.S, 213 cases were because of placenta previa which make about 3.8 %.out of 213 lscs 62 cases were done in emergency (29.1%).and 151 was done as elective cases(70.8). as far as age women's were concerned highest percentage of placenta previa was seen in age group of 31-36 years (35.2%) followed by age group of 26-30years (26.2%..Out of 213 women of placenta previa 144 (67.74%)women suffered from antepartum hemorrhage from moderate to severe bleeding .All women had lower segment caesarean section as mode of delivery whether in emergency or as an elective procedure dependent upon amount of bleeding ,gestational age and condition of mother. All patent had ultrasound done to confirm the localization of placenta and to exclude placenta accreeta or percreeta. 14 patient underwent bilateral uterine ligation and because of bleeding and severe nature of placental adherence out of 213 women 56 (26.29%) had caesarean hysterectomy and 6 patient received injuries to urinary tract in form of bladder injury or uretric injury which could be because of adhesion, excessive bleeding or difficult c/hysrectomy .By the bless of God there was no maternal death recorded in this period of study Conclusion: In summary, history of previous lower segment caesarean section were found to be associated increased rate of placenta previa and its severe form i.e. placenta accreta.It is also concluded that with good antenatal care we can pick patient who are at high risk of placenta previa and its related risk.
To study the maternal and perinatal outcomes in patients suffering from placenta previa
International Journal of Clinical Obstetrics and Gynaecology, 2021
Background: Placenta previa is a disorder which occurs during pregnancy that is characterized by the presence of placental tissue close to or covering the cervix increasing the risk of antepartum, intrapartum and postpartum hemorrhage. Rapid significant loss of intravascular volume can lead to hemodynamic instability, decreased oxygen delivery, decreased tissue perfusion, cellular hypoxia, organ damage and death. Infants born to such patients are also at risk of premature deliveries and increased perinatal mortality. Method: This prospective randomized clinical study was conducted in the Department of Obstetrics & Gynecology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh the period 2018-2020 after considering the inclusion and exclusion criterias. Result: Primigravida were more affected than multigravia. Majority patients underwent Emergency LSCS than Elective one. PPH, Pre-operative and Post-operative anaemia and Adherent placenta was significantly more among Emergency LSCS. NICU admission was significantly more among Emergency LSCS. Conclusion: The current study suggested that there is an association between advancing age, previous caesarean section and abortion as the risk factors for placenta previa. Placenta previa as noted from the study was seen to be associated with increased risk of maternal complications like PPH and neonatal complications including prematurity and low birth weight.
An Overview on Diagnosis & Management of Placenta Previa
World Journal of Environmental Biosciences, 2021
Placenta previa is defined as low placental implantation that covers the internal os of the cervix; either completely or partially. The condition sometimes is discovered incidentally in routine antenatal care screening, while some present with frank second or third trimester painless vaginal bleeding. The rate of placenta previa in Saudi Arabia is 4.1 per 1000 births, where all are managed by caesarian delivery. We aimed to review the literature looking for the updated placenta previa in terms of risk factors, clinical presentation, diagnosis, and management. PubMed database was used for articles selection, gathered papers had undergone a thorough review. The complexity of placenta previa manifests in optimizing the outcome of both the mother and the baby. Early detection of the problem results in better outcomes due to wellplanned management and anticipation. The medical team should always involve the mother in the possible negative outcome and consider the possible complications as placenta previa sometimes coexist with other placental implantation abnormalities such as increta and precreta.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: 2-5% of the pregnancies are complicated by antepartum haemorrhage. About one third of them are due to placenta previa thus contributing to a significant amount of maternal and perinatal morbidity and mortality. In the present times with liberally increasing caesarean section rates, there is a changing trend in the incidence and complications of placenta previa. The objective of this study was to evaluate the obstetrical characteristics and maternal and perinatal outcome of cases of placenta previa.Methods: This was a prospective observational study conducted in the Department of Obstetrics and Gynaecology of JSS Medical College and Hospital, Mysore during the period January 2017 to June 2018.Results: Out of total 13,150 deliveries during this period, placenta previa was observed in 131 cases with an incidence of 1%. Majority belonged to the age group 25-29 years (48.8%). 66% of the cases presented with painless vaginal bleeding as their chief complaint. The major risk fa...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: The aim of this study was to determine clinical profile, evaluate our antenatal and intraoperative management and see the maternal and perinatal outcome in patients with placenta previa.Methods: A prospective study was carried out in 130 women with placenta previa in the Department of Gynecology, PGIMER, Chandigarh, India between Jan 2015–April 2016. The profile of these patients was recorded in a predesigned proforma and maternal and perinatal outcome analyzed in detail.Results: One third (46/130) of the patients with placenta previa had a history of previous caesarian section, 27% had previous uterine curettage and 82% were multiparous.18% were asymptomatic placenta previa whereas 82% had one or more bleeding episodes. Expectant management was given to 67% patients after first bleeding episode. Majority (92/130) of patients required emergency cesarean section. Due to invasive placentation, 25 patients required cesarean hysterectomy. Ninety percent patients required del...
Evidence Based Women's Health Journal, 2020
Aim: This study aimed to analyze maternal and neonatal outcome measures of placenta previa patients presented to Ain Shams university maternity hospital. Materials and Methods: A prospective study was conducted in Ain shams Maternity Hospital, in the period between September 2018 and February 2019. Study included 85 patients. Outcome measures: Maternal outcome measures included: Estimated blood loss, Amount of blood transfusion, Mode of delivery, Complications, pre and postoperative hemoglobin level, Postoperative fever, Postoperative wound infection, ICU admission. Neonatal outcome measures included: Neonatal weight, APGAR score, Prematurity, NICU admission, IUFD. Results: The Mean age (31.82 yrs), gravidity (4.06), parity (2.71), previous CS deliveries (2.52). Other RF: E and C (7.1%), hystrotomy (2.4%), twin pregnancy (2.4%), ICSI (1.2%) and IUD (1.2%). Mean blood loss (1576.47 ml). Mean used packed RBCs units (3.48 units), mean used FFP (3.12 units). Mean hospital stay (9.39 days). Uneventful CS delivery (54.1%), CS hysterectomy (42.4%) and CS delivery plus bilateral tubal ligation (3.5%). Complications(8.2%) including: UB injury (4.7%), intestinal injury(1.2%), ureteric injury (1.2%), aspiration (1.2%), post-partum haemorrhage(3.5%), fever (8.2%), wound infection (5.9%), ICU admission(12.9%). Mean pre-operative Hb level (11.01) and mean post-operative Hb levels (8.97). Mean GA on admission very preterm (11.8%), preterm (62.4%), term (25.9%). GA at TOP: very preterm (10.6%), preterm (45.9%) and term (43.5%). Mean birth weight (2599.18g), LBW (30.6%). APGAR scores at 1 minute; normal(42.4%), moderately depressed (40%), severely depressed(17.6%). At 5 minutes; normal(85.9%) moderately depressed(10.6%), severely depressed(3.5%). NICU admission(22.4%). IUFD (5.9%). Conclusion: Placenta previa has higher incidence rate with increasing maternal age, gravidity, parity and number of previous caesarean section deliveries. Placenta previa patients at risk of numerous maternal and neonatal morbidities, maternal morbidities include life threatening haemorrhage, caesarean hysterectomy, blood component transfusion, prolonged hospital stay and ICU admission. Neonatal morbidities include premature delivery, low birth weight, intrauterine foetal death and NICU admission.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2020
Background: Placenta previa is one of the major causes for obstetric hemorrhagic morbidity and mortality with increasing incidence in recent times. This study aims at determining risk factors, maternal and fetal outcome associated with placenta previa.Methods: This was an observational, retrospective study conducted at a tertiary care hospital in Mumbai from May 2017 to March 2020. A total of 102 women with placenta previa during the study period were included, their case records critically analyzed to identify risk factors, maternal outcome in relation with blood transfusion required, ICU admission, obstetric hysterectomy and fetal outcome pertaining to prematurity, asphyxia and mortality.Results: A total of 102 patients were analyzed. Placenta previa was more common in >26 years of age, multipara (64.7%), with previous history of caesarean sections (21.5%) and previous curettage (11.7%), 44.2% babies born were preterm, 4.4% stillbirths and 8.5% neonatal deaths. Maternal complic...
International Journal of Medicine, 2015
Background: The management of pregnancies complicated by placenta previa is best addressed in terms of the clinical setting: asymptomatic women, women who are actively bleeding and women who are stable after one or more episodes of active bleeding. Objective: To assess the management and outcome of placenta previa. Methodology: It was cross-sectional and hospital-basedstudy implemented during a time period of six months (July-December 2012) in Khartoum maternity hospital, and a total of50 women presented with VB diagnosed as placenta previa were selected through convenience sampling method. Results: Only two patients were deliver vaginally and C/S was done for 48(96.0%). Regarding outcome 16(32.0%) of patients were developed bleeding, 5(10%) of patients were ended by hysterectomy, 2(4%) developed acute renal failure, one maternal death and 26(52.0%) of patients were without obvious complications. Conclusions: The majority of women were undergone C/S and about (90.0%) their placenta were completely separated, (4.0%) left inside and (6.0%) left partially.
STUDY OF MATERNAL AND FETAL OUTCOME IN PLACENTA PREVIA IN A TERTIARY CARE CENTRE
International Journal of Advanced Research (IJAR), 2024
When the placenta is implanted partially or completely over the lower uterine segment (over and adjacent to the internal os) is called placenta previa.. The incidence of placenta previa has risen during the past 30 years. Reported incidences average about 0.4 percent or 1 case per 250 to 400 deliveries, It complicates 0.3-0.5% of all pregnancies at term.Classified in four types on the basis degree of extension of placenta to lower segment. Several demographic factors may contribute to this higher rate of placenta previa, are ,old maternal age, high parity, multifetal gestation, uterine surgery (curettage), smoking and cocaine use, and abortion.. Regardless of etiology, maternal and fetal risks are increased by several folds in patient of placenta previa; in mother, the risks are mainly due to life threatening APH and postpartum haemorrhage (PPH). Placenta previa is a major cause of antepartum haemorrhage (APH) accounting for 35% of all the causes. With regard to baby, incidences of low birth weight (LBW), intra uterine growth restriction (IUGR), preterm deliveries and congenital malformations are increased. 3 Classified in four types on the basis degree of extension of placenta to lower segment.