PLACENTA PREVIA AND PLACENTAL ABRUPTION: FREQUENCY AND FETOMATERNAL OUTCOMES

Abstract

Background: Placenta previa and placental abruption are important causes of antepartum hemorrhage and can lead to significant maternal and fetal complications. This study analyzed their incidence and compared their fetomaternal outcomes. Methods: A prospective observational comparative study was done in the Department of Obstetrics and Gynecology, Women and Children Hospital, Dera Ismail Khan. Pregnant women with a diagnosis of PP or PA after 20 weeks gestation were consecutively recruited for the study and followed up prospectively until delivery and maternal and neonatal discharge. Sociodemographic, obstetric, clinical, maternal, fetal and neonatal factors were documented. The data was analyzed with SPSS version 27. Appropriate parametric or non-parametric tests were used, as well as chi-square/Fisher's exact tests and multivariable logistic regression. Results: Of the 4,200 deliveries, 48 (1.14%) women experienced placenta previa and 52 (1.24%) women had a placental abruption. Placenta previa was more common than not (56.3% vs. 26.9%, p=0.003), and this was more likely to be associated with previous cesarean section. Earlier delivery, increased transfusion needs, postpartum hemorrhage, need for intensive care unit admission, decreased birth weight, Apgar score, fetal distress, need for NICU admission and stillbirth were associated with placental abruption. Severe antepartum hemorrhage (AOR=4.26; p=0.006), placental abruption (AOR=3.48; p=0.012) and preterm delivery (AOR=3.17; p=0.021) were independent predictors of adverse outcome. Conclusion: There were significant levels of fetomaternal morbidity in both conditions and a higher degree of adverse outcomes in cases of placental abruption.