MATERNAL AND PERINATAL OUTCOME IN CASES OF PLACENTA PREVIA- AN OBSERVATIONAL RECORD-BASED STUDY IN A TERTIARY CARE HOSPITAL IN JHARKHAND
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 44
Abstract
BACKGROUND Placenta previa is an Obstetrical condition with high foetomaternal complication. Placenta previa is found in 1/3rd cases of antepartum haemorrhage. This study was conducted to find out demographic profile, maternal and perinatal outcome in cases of Placenta previa in our Institution. MATERIALS AND METHODS This study was done at Rajendra Institute of Medical Sciences in the Department of Obstetrics and Gynaecology (O and G) from January 2013 to December 2016. The cases admitted in Labour room and OPD with period of gestation more than 28 weeks with painless vaginal bleeding or diagnosed as having Placenta previa on routine ultrasonography were included in this study. All antenatal women in this study were evaluated with comprehensive maternal history, clinical, laboratory and ultrasound examination and demographic profile, type of Placenta previa, previous method of delivery and its impact on present pregnancy and mode of delivery along with maternal and perinatal outcome. RESULTS A total of 135 patients with Placenta previa were identified. Two-thirds of women were unbooked. One-half of total patients were between 20 - 25 years. Two-thirds of women were multigravida and 62.22% patients were multiparous. Type 4 Placenta previa was in 32.59%. There was history of previous surgeries in 49.63%. Half of total patients were admitted at 35 to 37 weeks of gestation. Normal delivery is in 11.11% cases and 15 babies were still born. A one-third of total babies were admitted in NICU. Three-fifths patients presented with antepartum haemorrhage and one-third patients had postpartum haemorrhage. Morbidly adherent placenta was found in 8 patients (5.92%) and hysterectomy was done in 12 patients (8.89%). Balloon tamponade and vaginal packing was done in 8 patients (5.92%). Blood transfusion was needed in 115 patients (85.18%). Wound infection, febrile illness and prolonged hospital stay was also found in this study. There was one case of bladder injury (0.74%) intra-operatively and 2 maternal death (1.48%) was found. CONCLUSION Placenta previa causes threat to foetal and maternal health and contribute to significant rise in foetomaternal morbidity and mortality. It is a great challenge to Obstetrician and needs lot of skill and experience to deal with it. Early diagnosis, timely intervention, blood transfusion facility and a team of skilled obstetrician, paediatrician and anaesthetist can improve the outcome.
Authors and Affiliations
Kiran Trivedi, Shashi Bala Singh, Megha Bhagat, Rashmi Kumari
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