Mahnaz Raees, Zeenat Parveen, Mustafa Kamal.
Fetal and maternal outcome in major degree placenta previa.
Gomal J Med Sci Jan ;13(3):173-6.

Background: Placenta previa is associated with significant maternal and fetal morbidity and mortality. This study was conducted to determine the feto-maternal outcome of pregnancies complicated by major degree placenta previa. Material & Methods: This cross-sectional study was conducted at Department of Gynaecology & Obstetrics, Lady Reading Hospital, Peshawar, Pakistan, from March 25, 2007 to March 24, 2008. Fifty pregnant, ultrasonographically confirmed cases of major degree placenta previa were assessed for maternal and fetal outcome of pregnancies. Results: The mean age of patients was 29.98+7.15 years. Maximum number of cases 26(52%) were in 21-30 years age group. Regarding gravidity 28(56%) were multigravida, 9(18%) grand multigravida, 8(16%) great grand multigravida and 5(10%) primigravida. Regarding parity 25(50%) were multipara, 9(18%) grand multipara, 6(12%) primipara, 5(10%) great grand multipara and 5(10%) nullipara. Gestational age at presentation was in 24(48%) as 33-36 weeks, 19(38%) at 37-40 and 7(14%) at 28-32 weeks. Regarding fetal outcome, 42(84%) neonates were alive and 8(16%) dead. Birth weight ranged from 1.8 to 4 kg mean 2.75+0.58. Regarding APGAR score, 34(68%) had >7, 8 (16%) <7 and 8 (16%) 0 score. Eighteen (36%) neonates were admitted to NICU. Two (4%) babies were diagnosed as having anemia and 12(24%) developed jaundice. Among maternal complications, surgical and anesthesia complications occurred in 2(4%), postpartum sepsis in 4(8%), hypovolumic shock in 15(30%), placenta accreta in 2(4%) and postpartum hemorrhage in 14(28%). Maternal anemia was recorded in 38(76%) cases and length of hospital stay ranged from 4 to 59 days mean 9.16+8.46. No maternal death was recorded. Conclusion: Major degree placenta previa is associated with high maternal and neonatal morbidity and neonatal mortality. Ladies with age range 21-30 years and multipara are commonly affected. APGAR score <7, admission to neonatal intensive care unit, respiratory distress syndrome, anemia, jaundice, and neonatal death, are the common neonatal complications. Maternal anemia, hypovolemic shock, postpartum hemorrhage and sepsis are the commonest maternal complications.

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