Placenta praevia is a major antenatally identifiable risk factor for obstetric haemohage particularly in women with a previous uterine scar7. Because of the speed with which obstetric hemorrhage at delivery can become life threatening the caesarean hysterectomy, internal iliac artery

OBJECTIVES: To evaluate the frequency, associated risk factors and maternal out come in women presenting with major degree of placenta praevia. STUDY DESIGN : Descriptive case series study. PLACE AND DURATION OF STUDY : Department of Gynaecology and Obstetrics unit 1 Sheikh Zayed Women Hospital & Chandka Medical College Larkana from 1st January 2008 to 31 Dec 2008. PATIENTS AND METHOD : Total 50 patients were included in this study with major degree of placenta praevia (type 111, IV) diagnosed on ultrasound presented with painless vaginal bleeding after 28 wks of pregnancy. The patient having antepartum haemorrhage due to minor placenta praevia, abruptio placenta and incidental causes were excluded. There out come variable were entered in proforma and results were evaluated. RESULTS : Total numbers of deliveries during the study period were two thousand and fifty. Among them ninety two cases presented with Antepartum hemorrhage. Seventy one had placenta previa giving the frequency of 3.46%. 50 had major degree of placenta previa (2.43%) while 21 (1.02%) had minor degree of placenta previa. Majority of patients were between 20-35 years of age and were grand multipara. Six patients had previous history of placenta praevia, twelve had history of Caesarian section. 15 patients presented with life threatening hoemoharge in state of shock. 46 patients delivered by cesarean section, while 4 patients had obstetrical hysterectomy. 10 patients had postpartum haemorrhage, 1 patient developed DIC, and 15 had puerperal sepsis. 9 had UTI, 4 had wound infection, 2 developed renal failure. None of the patient expired in this study. CONCLUSION : Placenta previa is associated with high maternal morbidity because of lack of diagnoses and blood transfusion facilities in rural areas Frequency of placenta praevia was 3.46% and found to be more common in young age and in grand multipara. Previous scar in uterus was a major risk factor.