Impact of placenta previa on obstetric outcome (original) (raw)
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Objective: The objective of this study is to compare the incidence of placenta previa in women who underwent cesarean section previously versus vaginal deliveries and to compare maternal and fetal outcomes in subjects with placenta previa among previous cesarean section and vaginal deliveries. Method: Prospective study conducted in 50 previous Lower Segment Cesarean Section and 50 previous Normal vaginal delivery cases. Women were enrolled in the study in Mid Trimester, 12-20 weeks of Gestational Age followed until 1 week after delivery. Results: Among the 50 women who underwent normal vaginal delivery one case of placenta previa was observed whereas among the 50 women who underwent previous cesarean sections four women developed placenta previa in their successive pregnancies. The maternal outcome was almost similar in both whereas the fetal complications i.e., Low Birth Weight, Low APGAR Score and the necessity for NICU admission were more in women with placenta previa who underwent cesarean section previously. Conclusion: Incidence of placenta previa was higher in Post Cesarean Delivery. Among the study group,2% of cases with placenta previa in patients with Normal Vaginal Delivery and 8% of cases with placenta previa in post cesarean pregnancies was observed. Fetal and Maternal complications are high in patients with placenta previa with previous cesarean sections.
Risk factors and pregnancy outcome in different types of placenta previa
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2009
To compare risk factors and pregnancy outcome between different types of placenta previa (PP). We conducted a retrospective study of 306 women presenting with PP over a 10-year period from January 1996 to December 2005. Differences between women with major and minor PP regarding age, parity, history of Caesarean section, antepartum hemorrhage, preterm deliveries, placenta accreta, Caesarean hysterectomy, operative complications, and neonatal outcome were identified using Mann-Whitney U test, chi-square test, and multivariate logistic regression. The overall incidence of PP was 0.73%. Major PP (complete or partial PP) occurred in 173 women (56.5%) and minor PP (marginal PP or low-lying placenta) in 133 women (43.5%). There were no differences between women with major and minor PP regarding age, parity, and previous miscarriages. After controlling for confounding factors, women with major PP showed a significantly higher incidence of antepartum hemorrhage (OR 3.18; 95% CI 1.58-6.4, P ...
Critical analysis of risk factors and outcome of placenta previa
Archives of Gynecology and Obstetrics, 2011
Objective To investigate risk factors and pregnancy outcome of patients with placenta previa. Methods A population-based study comparing all singleton pregnancies of women with and without placenta previa was conducted. StratiWed analysis using multiple logistic regression models was performed to control for confounders. Results During the study period, there were 185,476 deliveries, of which, 0.42% were complicated with placenta previa. Using a multivariable analysis with backward elimination, the following risk factors were independently associated with placenta previa: infertility treatments (OR 1.97; 95% CI 1.45-2.66; P < 0.001), prior cesarean delivery (CD; OR 1.76; 95% CI 1.48-2.09; P < 0.001) and advanced maternal age (OR 1.08; 95% CI 1.07-1.09; P < 0.001). Placenta previa was signiWcantly associated with adverse outcomes such as peripartum hysterectomy (5.3 vs. 0.04%; P < 0.001), previous episode of second trimester bleeding (3.9 vs. 0.05%; P < 0.001), blood transfusion (21.9 vs. 1.2%; P < 0.001), maternal sepsis (0.4 vs. 0.02%; P < 0.001), vasa previa (0.5 vs. 0.1%; P < 0.001), malpresentation (19.8 vs. 5.4%; P < 0.001), postpartum hemor-rhage (1.4 vs. 0.5%; P = 0.001) and placenta accreta (3.0 vs. 1.3%; P < 0.001). Placenta previa was signiWcantly associated with adverse perinatal outcomes such as higher rates of perinatal mortality (6.6 vs. 1.3%; P < 0.001), an Apgar score <7 after 1 and 5 min (25.3 vs. 5.9%; P < 0.001, and 7.1 vs. 2.6%, P < 0.001, respectively), congenital malformations (11.5 vs. 5.1%; P < 0.001) and intrauterine growth restriction (3.6 vs. 2.1%; P = 0.003). Using another multivariable logistic regression model, with perinatal mortality as the outcome variable, controlling for confounders, such as preterm birth, maternal age, etc., placenta previa was not found as an independent risk factor for perinatal mortality (weighted OR 1.018; 95% CI 0.74-1.40; P = 0.910). Conclusions Infertility treatments, prior cesarean section, and advanced maternal age are independent risk factors for placenta previa. An increase in the incidence of these risk factors probably contributes to a rise in the number of pregnancies complicated with placenta previa and its association with adverse maternal and perinatal outcomes. Careful surveillance of these risk factors is recommended with timely delivery in order to reduce the associated complications.
Placenta previa: risk factors, feto-maternal outcome and complications
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2019
Background: Placenta previa is defined as placenta that is implanted somewhere in the lower uterine segment either over or very near the internal cervical os. Placenta previa and coexistent accrete syndromes contribute substantively to maternal and perinatal morbidity and mortality. Methods: All This is a retrospective study of 88 cases of placenta previa, which were admitted under department of obstetrics and gynecology in our institute during July 2017 to June 2019. All patients of placenta previa with gestational age > 28 weeks up to full term were included in the study. All cases were confirmed by ultrasound examination. Outcome measures prevalence of placenta previa, maternal and neonatal outcomes, and case fatality rate. Results: The total number of deliveries performed during the study period was 16330, of them, 88 cases were placenta previa. Thus, the prevalence of PP was 0.53%. Multiparity was one of the etiological factors in 84.09%, whereas previous LSCS was 47.73%, previous H/O D and E was 14.73%, previous H/O placenta previa was 7.95%. Obstetric hysterectomy was done in 7 (7.95%) patients out of 88 patients. 92.04% of patients delivered with cesarean section and 7.95% patients delivered with normal vaginal delivery. 22 (26.50%) babies out of 83 live born were admitted in NICU. Conclusions: Advancing maternal age, multiparity, prior cesarean section, and prior abortions are independent risk factors for placenta previa. Placenta previa remains a risk factor for adverse maternal and perinatal outcome. The detection of placenta previa should encourage a careful evaluation with timely delivery to reduce the associated maternal and perinatal complications. Measures to reduce the primary caesarean section rate should be adopted.
Determinants of placenta previa: a case-control study
Biomedical Research and Therapy, 2017
Background: The risk factors of placenta previa differ around the world. This study evaluated risk factors of pregnancies complicated with placenta previa during a 5-year period in a referral center in Hamadan, Iran. Methods: This case control study was conducted in Hamadan city (Hamadan Province of Iran) from April 2013 to March 2017. The cases were women whose deliveries were complicated by placenta previa and the controls were those who delivered without placenta previa. We recruited 130 cases and 130 controls. Multivariate unconditional logistic regression analysis was conducted, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: The OR of placenta previa was 4.08 (95% CI= 1.44, 11.58) by maternal age, 4.08 (95% CI =1.44, 11.58) by preterm labor, and 6.64 (95% CI =1.09, 40.45) by prior operations of the uterine cavity, compared to normal deliveries and after adjusting for other variables. Multiparity, prior spontaneous abortions, and prior cesarea...
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.
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.
The Impact of Previous Cesarean Section on The Outcome in Patients With Non-Adherent Placenta Previa
2020
Background: to evaluate the impact of lower segment cesarean section (LSCS) on the maternal and fetal outcomes of women with non-adherent placenta previa (PP). Methods: This is a retrospective study of all women who delivered at our hospital by LSCS with nonadherent PP over a period of 10 years. Data were obtained through hospital registry and medical records search. Data were analyzed using the Statistical Package for Social Sciences (SPSS, version 20). The differences in demographic and obstetric characteristics, peripartum complications, and fetal outcomes between women with no previous CS and those with previous CS were analyzed using t test or chi-square test wherever appropriate. A p-value of less than 0.05 was considered statistically signi cant. Results A total of 90 women with non-adherent placenta were included, 54 women with no previous CS and 36 women with previous CS. Women with previous CS were signi cantly more likely to experience organ injury (p-value <0.005), transfusion of ≥ 4 units of PRBC (p-value = 0.034), transfusion of FFP (pvalue = 0.034), and hysterectomy or other procedure (B Lynch, Uterine artery ligation) use (p-value <0.005) Conclusion: There is a signi cant increase in the incidence of maternal morbidities such as hysterectomy, blood transfusion and organ injury in patients with non-adherent PP with previous CS, with no difference in perinatal outcome in the same group of patients.
Fetomaternal Outcome with Placenta Previa and Morbidly Adherent Placenta, A Cross Sectional Study
International Journal of Contemporary Medical Research [IJCMR], 2020
Introduction: Placenta previa occurs when a baby's placenta partially or totally covers the mother's cervix or the outlet for the uterus. The aim of this descriptive retrospective cohort study was to identify maternal complications, placental position, mode of delivery, management and fetal outcomes in Placenta Previa (PP) and Morbidly adherent placenta Materail and methods: Study was conducted in Department of Obstetrics and Gynecology, Pak Red Crescent Medical and Dental College (PRCM&DC) Hospital Lahore from June 2017 to June 2019. A total of 62 pregnant women were registered. All booked and un-booked mothers with and without history of previous section with provisional clinical and/or USG diagnosis of Placenta Previa or MAP. Results: In total, 62 patients with PP were identified 22.58% patients with morbidly adherent placenta were unbooked and other wise are booked. 61.2% patients were the age group between 20-30 years and remaining are more than 30 years. In 25.8% type IV placenta previa and same 25.8% are morbidly adherent placenta and remaining are type I,II &III PP. Placenta previa, only 6.45% cases were diagnosed in 2 nd trimester and 93.5% cases were diagnosed in 3 rd trimester. Conclusion: Placenta Previa and Morbidly adherent placenta are not a very uncommon condition. Frequency of Incidence increases as the rate of cesarean section or abdominal surgery were increases. Early diagnoses and pre plan mode of delivery will decrease the risk of low birth weight and low APGAR score infants.
Obstetric risk factors associated with placenta previa development: case-control study
Croatian medical journal, 2003
AIM To evaluate potential risk factors and perinatal outcome of pregnancies complicated with placenta previa in Croatian population of pregnant women recruited from the largest tertiary care perinatal center in Croatia. METHODS This retrospective case-control study included a total of 202 singleton pregnancies with placenta previa during a 10-year study period and 1,004 randomly selected simple singleton controls. Data on potential risk factors for placenta previa development were carefully extracted from medical records, reviewed, and compared with a control group of women. Data were statistically analyzed with chi-square test and Mann-Whitney U test, and crude odds ratio (OR) with 95% confidence interval (95% CI) were provided. RESULTS The incidence of placenta previa was 0.4%. Factors significantly associated with a placenta previa development were advanced maternal age (especially >34 years, even after adjustment for high parity), gravidity of 3 and more (OR, 4; 95% CI, 2.5-6...