Placenta Previa; Prevalence, Risk Factor and Outcome

Aim: To find out the prevalence of placenta previa, obstetrical risk factors and fetomaternal complications. Study design: It was a prospective observational study. Setting: The study was carried out in the department of obstetrics and gynaecology at Sharif Medical City Hospital, from January1st2010 to December 31st 2013. Result: During the study period there were 2401 births at Sharif Medical City. Amongst them 1385 were by Caesarean Section. Thirty seven patients had placenta previa, giving its prevalence of 1.54%. Mean maternal age was 29.63+ 4.59 years (range 22 – 40 years). Only 5 women (14%) were >35 years of age, while 86% of women were <35 years of age. Three women were primigravida while 34 were multigravida. Among them, 18 (48.64%) had previous caesarean section, 7 (18.91%) had history of abortion followed by curettage and one woman (2.7%) had previous myomectomy. Eight (21.62%) had no previous uterine surgery. Average blood loss was 1724.24 + 631.48 ml (range 1000 – 3500 ml). Seven patients underwent emergency hysterectomy. Four of them had bladder injury. Two patients developed disseminated intravascular coagulation. One patient had hepatic and renal failure. Average gestation at the time of delivery was more than 35 weeks (35.165 + 3.32 weeks) and average birth weight of neonate was more than 2.5kg (2.51 + 0.65kg). Conclusion: Multiparity and previous caesarean sections are the most important risk factors for placenta previa Maternal complications are because of massive haemorrhage and fetal complications are due to prematurity