Maternal Complications and Outcomes in Women with Major Placenta Previa

Open Access

Abstract

Introduction: Placenta previa is a condition in which the placenta implants in the lower uterine segment and partially or completely covers the internal cervical os. Major placenta previa, in which the placenta covers the cervical os, is a significant obstetric complication that may result in severe antepartum haemorrhage, haemorrhagic shock, operative complications, postpartum haemorrhage, and maternal death. This study aimed to assess the maternal complications and outcomes among women with major placenta praevia. Methods & Materials: This cross-sectional observational study was conducted in the Department of Obstetrics and Gynaecology, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh, over six months from May 2013 to October 2013. A total of 50 patients with major degree placenta praevia were enrolled using a purposive sampling technique. Data were analysed using SPSS 20.0. Results: Among 50 patients with major placenta praevia, 46.0% were aged 27-31 years and 60.0% had parity 2-4; 66.0% belonged to the lower socioeconomic class, while 50.0% had irregular and 30.0% had no antenatal care. Most patients (82.0%) had no intraoperative complications, with placenta accreta being the most frequent complication (8.0%). Postoperatively, anaemia (30.0%) and PPH (22.0%) were the leading complications. Maternal mortality was 4.0% (2/50), with both deaths resulting from severe haemorrhage. Conclusion: The study demonstrated that major placenta praevia was responsible for substantial maternal morbidity, with haemorrhage representing the principal clinical challenge. Haemorrhagic presentation occurred in 64.0% of the patients, and 14.0% developed haemorrhagic shock. Among intraoperative complications, placenta accreta was the most frequent, occurring in 8.0% of cases. Postoperatively, anaemia (30.0%) and postpartum haemorrhage (22.0%) were the predominant complications. Maternal death occurred in 4.0% of the patients, with severe haemorrhage being the underlying cause in both fatal cases.