The Prevalence, Predisposing Factors and Pregnancy Outcome in Patients with Placenta Praevia at the University of Calabar Teaching Hospital: A Six Year Review

Abstract

Background: Placenta praevia, a serious cause of obstetric haemorrhage, is potentially life-threatening to the mother and often results in high maternal and perinatal morbidity and mortality.
Objectives: To find out the prevalence, predisposing factors and pregnancy outcome of placenta praevia over a six-year period in the University of Calabar Teaching Hospital, Calabar, Nigeria.
Methodology: This was a retrospective study of cases of placenta praevia managed within the University of Calabar Teaching Hospital from 1st January 2014 to 31st December 2019. Patients data were retrieved and entered into an excel sheet and statistical analysis performed using STATA 16.
Results: A total of 10,665 deliveries over the 6-year period and 140 cases of placenta praevia were recorded giving a prevalence of 1.31%. Type III placenta praevia was the most common found in 51(36.4%) of cases and 98(70%) were major degree placenta previa. The mean age of the patients was 30.7 ± 4.4 years and 92(65.71%) were multiparous. Scarred uterus 22(15.71%) from endometrial curettage and previous caesarean section 18(12.86%) were the most common predisposing factors. Antepartum haemorrhage was seen in over half the women that presented (95 (67.14%), 32 (22.86%) had post partum haemorrhage and one maternal death (0.71%) was recorded. Up to 67.14% of the parturients presented at term. Fetal complications were prematurity (67.19%), birth asphyxia (18.57%), low birth weight (27.14%), still births (14, 10%) and 5 (3.5%) early neonatal deaths.
Conclusion: Advancing maternal age, multiparity and scarred uterus were the main risk factors for placenta praevia in the study. Maternal and Perinatal survival rates were fairly high but with marked life-threatening complications.

Key words: Pregnancy, Placenta previa, Antepartum haemorrhage, Risk factors, Prematurity