Different Types of Placenta Previa and Association with Pregnancy Outcomes at a Tertiary Care Hospital of Developing Country

Zara Mumtaz; Qurat-Ul-Ain; Naushin Farooq; Sadia Kanwal; Tehmina Kanwal; Sana Faiq

Zara Mumtaz Resident of Gynae and OBS, Federal Govt polyclinic Islamabad
Qurat-Ul-Ain Associate surgeon gynae (Inchrage Gynae unit-II), Federal Govt polyclinic Islamabad
Naushin Farooq Surgeon gynae (HOD), Federal Govt polyclinic Islamabad
Sadia Kanwal Associate surgeon gynae, Federal Govt polyclinic Islamabad
Tehmina Kanwal Associate surgeon gynae, Federal Govt polyclinic Islamabad
Sana Faiq Medical officer, Federal Govt polyclinic Islamabad

Abstract

Objective: To determine the frequency of different types of placenta previa (PP) and its association with pregnancy outcomes in a tertiary care hospital of developing county.

Methodology: This descriptive cross-sectional study was done at department of Obstetrics & Gynecology of Federal Government Polyclinic Islamabad After taking approval from the hospital’s Ethical Committee. Study duration was one year from 1st Jan., 2023 to 31st December 2023. Pregnant women visiting antenatal OPD with low lying placenta on ultrasound in third trimester, women coming to labour room or emergency with Antepartum hemorrhage and having low lying placenta on ultrasound and those who were referred to obstetric department by any clinic or hospital of either age of women and parity were included. Types of placenta were determined by ultrasound or MRI. All the information was collected via study proforma and analyzed using SPSS version 26.

Results: A total of 55 women having placenta previa were studied, with 89.1% aged over 25 years. Majority of women (65.5%) were admitted through the outpatient department, and 94.5% were booked patients. 52.7% women had major degree of PP and remaining 47.3% had minor degree of PP. Most deliveries (70.9%) were elective C-sections, with 25.5% being emergency C-sections and only 3.6% spontaneous vaginal deliveries. Major PP cases were associated with a higher incidence of surgical complications, including hemorrhage (7.3%), cesarean hysterectomy (9.1%), and bladder injury (5.5%). Intraoperative transfusions were needed in 20% of major cases but none in minor cases, and ICU admissions were more frequent in the major group (10.9% vs. 1.8%). Hospital stays were longer for major placenta previa. Neonatal ICU admissions were significantly higher in major cases (18.2% vs. 1.8%, p=0.001).

Conclusion: As per the study conclusion, 52.7% of the women had major placenta previa, while the remaining 47.3% had minor placenta previa. Major placenta previa was associated with a higher risk of both maternal and neonatal complications compared to minor placenta previa.