Original Research Article
Year: 2020 | Month: October-December | Volume: 5 | Issue: 4 | Pages: 42-52
Maternal and Fetal Outcomes in Pregnant Women with Major Degree Placenta Previa at ESIC MC and PGIMSR
Shakuntala. P.N**, Chandana.H.S*, Nagesh Gowda.B.L*, Ashok Kumar***, Renuka Ramaiah****
*Junior Resident, **Assistant Professor, ***Professor, ****Director Professor and Head of Department,
Department of Obstetrics and Gynaecology,ESIC MC and PGIMSR, Rajajinagar, Bengaluru- 560010.
Corresponding Author: Shakuntala. P.N
ABSTRACT
Background and aim: Placenta previa describes a placenta implanted in lower uterine segment either on or very near the internal os (1:300 pregnancies). With an increasing rate of cesaerean section, the incidence of placenta previa and its complications are increasing. Hence, we undertook the present study with an aim to identify the risks factors and to study the maternal and fetal outcomes in major degree of placenta previa.
Methods: A Prospective Observational study- January 2019 to June 2020 at ESIC MC and PGIMSR, Rajajinagar, Bengaluru, in the Department of Obstetrics and Gynaecology. Demographic profile, risk factors, preoperative, intraoperative and postoperative maternal and fetal events were recorded.
Results: Among 5000 deliveries, 37 women were diagnosed with placenta previa ( 0.74%). Median age 26years, multiparity[25,67%], previous cesarean section[14,37%], previous abortions[13,35%]. Major degree placenta previa (31,83%), antepartum hemorrhage (9,24%), anterior placenta previa (24, 64%). 24 (64%) underwent emergency cesaerean section with a mean estimated blood loss of 1500ml. Massive transfusions were done in 2(5.4%) women with adherent placenta. Haemostatic sutures were used in 32(86.5%) women. 2 (5.4 %) underwent cesarean hysterectomy. 3(8.1%) had a near miss and needed ICU care. Mean baby weight was 2500 grams ±400 grams. NICU admission 13(35.1 %) was prematurity. Neonatal mortality was 2(5.4%).
Conclusion: Prudent decisions to reduce the scarring of uterus could prevent major degree of placenta previa. Institutional delivery where there is availability of skilled multispeciality team with robust blood bank facilities is the cornerstone to avert maternal and neonatal deaths.
Keywords: Placenta previa, cesarean hysterectomy, blood transfusion, prematurity.