Study Of Fetomaternal Outcome In Cases Of Placenta Previa At Tertiary Care Hospital, Dhaka, Bangladesh

  • Kulsum U Assistant Professor, Dept. Of Fetomaternal Medicine, BSMMU, Dhaka, Bangladesh
  • Akthar N Professor, Dept. Of Fetomaternal Medicine, BSMMU, Dhaka, Bangladesh
  • Parveen T Professor, Dept. Of Fetomaternal Medicine, BSMMU, Dhaka, Bangladesh
  • Qumruzzaman K Assistant Professor, Department of Cardiology, BSMMU, Dhaka, Bangladesh
  • Wahid F Assistant Professor, Dept. Of Fetomaternal Medicine, BSMMU, Dhaka, Bangladesh
  • Islam N Assistant Professor, Dept. Of Fetomaternal Medicine, BSMMU, Dhaka, Bangladesh
  • Begum Z Assistant Professor (Obs and Gynae), Bangabandhu Sheikh Mujib Medical College (BSMMC), Faridpur, Bangladesh
  • Kulsum SU Assistant Professor (General Obs and Gynae), BSMMU, Dhaka, Bangladesh
Keywords: Placenta previa, placenta accreta spectrum, cesarean section, peripartum hysterectomy, fetomaternal outcome

Abstract

Background: Placenta previa remains a significant obstetric challenge associated with substantial maternal and fetal morbidity. The increasing incidence of placenta previa and its associated complications, particularly in the context of rising cesarean section rates, necessitates ongoing evaluation of management strategies and outcomes.

Objective: To assess the fetomaternal outcomes in cases of placenta previa managed at a tertiary care hospital and to identify risk factors associated with adverse outcomes.

Methods:This retrospective observational study analyzed 60 cases of placenta previa managed at FetomaternalMedicine Dept., BSMMU, Dhaka, Bangladesh between June 2023 to June 2024.Data on maternal characteristics, obstetric factors, management strategies, and fetomaternal outcomes were collected from medical records. Statistical analysis included descriptive statistics and multivariate logistic regression to identify risk factors for adverse outcomes.

Results: The mean maternal age was 29.2 ± 4.3 years, with 75% of patients having a history of previous cesarean sections. Placenta previa was diagnosed in 76.7% of cases, andlow lying placenta were present in 23.3%. Peripartum hysterectomy was performed in 41.7% of cases. The preterm delivery rate was 70%, with a mean gestational age at delivery of 35.6 ± 2.8 weeks. Neonatal intensive care unit admission was required for 36.7% of newborns, and the perinatal mortality rate was 3.3%. Multivariate analysis identified previous cesarean sections (≥2) (adjusted OR 3.8, 95% CI 1.7-8.5) and placenta accreta spectrum disorders (adjusted OR 12.5, 95% CI 4.2-37.1) as significant risk factors for peripartum hysterectomy.

Conclusion: This study highlights the significant maternal and fetal morbidity associated with placenta previa, particularly in cases with previous cesarean sections and placenta accreta spectrum disorders. The findings underscore the importance of early diagnosis, multidisciplinary management, and the need for specialized care in tertiary centers for high-risk pregnancies. Strategies to reduce primary cesarean section rates and careful counseling for women with a history of cesarean delivery are crucial in addressing this growing obstetric challenge.

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How to Cite
Kulsum, U., Akthar, N., Parveen, T., Qumruzzaman, K., Wahid, F., Islam, N., Begum, Z., & Kulsum, S. U. (2024). Study Of Fetomaternal Outcome In Cases Of Placenta Previa At Tertiary Care Hospital, Dhaka, Bangladesh. Obs Gyne Review: Journal of Obstetric and Gynecology, 10(1), 32-39. Retrieved from https://obstetrics.medresearch.in/index.php/joog/article/view/171
Issue
Vol 10 No 1 (2024): Jan-Dec
Section
Original Article

Copyright (c) 2024 Author (s). Published by Siddharth Health Research and Social Welfare Society

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