Major degree placenta praevia;

Introduction: Placenta praevia is a major cause of maternal & fetal morbidity and mortality. It is a major cause of obstetrical haemorrhage in second and third trimester of pregnancy. Placenta pravia usually presents with antepartum haemorrhge and as a source of maternal morbidity, it remained a significant cause of hospitalization and caesarean section. The study was carried out to see the frequency of risk factors, maternal complications and perinatal outcome in major degree placenta praevia. Objectives: I). To Find out major risk factors and maternal complications in major degree placenta praevia. II). Know perinatal outcome in major degree placenta praevia. Study Design & Techniques: It is a descriptive study. Patients were selected by simple random sampling techniques. Settings: The study was carried out at Gynae Unit-I, Allied Hospital, Faisalabad from March 2005 to February, 2006. Subjects & Method: Seventy five patients selected for the study after fulfilling the inclusion criteria for major degree placenta praevia. The included patients were examined thoroughly and relevant information was recorded into proforma giving detailed history, clinical examination, investigation and management. Results: In this descriptive study, total 75 patients were included as a diagnosed a case of major degree placenta praeiva. There were 15 patients presented asymptomatically and the rest of 60 patients were symptomatic. Out of 75 patients, majority of the patients belonged to the age group of 24-35 years. The mean age was 31.5 years. 2 patients expired due to massive PPH, 10 patients underwent obstetrical hysterectomy. In these 10 patients, 3 patients had placenta accrete, 1 patient had placenta increta and 2 had placenta percreta. Predisposing factors were previous gynaecological operations in 15 patients, history of previous C-section in 14 patients, history of previous placenta praevia 8 patients, advanced maternal age 5 patients and history of myomectomy in 3 patients. The remaining 39 patients had no predisposing risk factor. The mean gestational age was 36 weeks. 57 babies were delivered by emergency C-section and the remaining 18 patients underwent elective C-section. Live birth account was 66. Out of 75 babies, 9 babies were IUD, 48 were preterm, 17 were IUGR, 25 babies were having RDS and 3 babies were abnormal congenitally and 13 perinatal deaths occurred. Conclusions: Significant improvement in the neonatal care should be achieved in our tertiary environment to improve expected survival rate together with a reduction in overall morbidity for the premature new born.