Incidence of placenta previa in Southern Punjab and maternal outcome

Abstract

Placenta previa is a worldwide problem associated with many pregnancy related complications. However, the information regarding placenta previa and its effect on pregnancy outcome are lacking in this area of Pakistan. This study aims to find out incidence of placenta previa in pregnant females, its consequences and outcome of pregnancy in the local population of Southern Punjab admitted to tertiary care public sector hospital at Rahim Yar Khan region. Patients and Methods: This observational cross sectional study was conducted in the department of Obstetrics and Gynaecology, Sheikh Zayed Hospital, Rahim Yar Khan from March to November 2017 on 4658 pregnant females. Gravid females with vaginal bleeding after 28 weeks gestation underwent ultrasonography to assess placenta previa. Findings of placenta previa were noted and females were followed-up till they were discharged and complications, including obstetrical hysterectomy, anemia, disseminated intravascular coagulation (DIC), multi-organ dysfunction or failure, blood transfusion requirement and maternal death, were recorded. Results: Mean age of the patients was 33.2±5 years and mean gestational age at presentation was 35.38±3 weeks. Out of the 4658 females, 2402 (51.6%) underwent spontaneous vaginal delivery and 2256 (48.4%) underwent cesarean section. Among 2256 females who underwent cesarean section, 210 (9.3%) had placenta previa. Among them, 38 (18%) had obstetrical hysterectomy, 4 developed DIC, 2 had multi-organ failure and 2 (0.95%) died, whereas 198 patients received multiple blood transfusion. Conclusion: The frequency of placenta previa was lower in local female population presenting at a tertiary care hospital for delivery. However, the complications were high in females with placenta previa and hysterectomy was one of the major complications of pregnancy with placenta previa.