Title: Placenta Praevia: Diagnosis and Management outcomes in a Medical Centre, South East Nigeria

Authors: Nkwo Emeka.Chinedum, Onoh Robinson Chukwudi, Nkwo Glory Chinedum Emeka, Oraekwe Obinna

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.64

Abstract

Background: Maternal as well as perinatal morbidity and mortality from placenta praevia could be considerable. Early diagnosis, and appropriate management could reduce significantly unfavourable fetomaternal outcomes associated with placenta praevia.

Objective: This study sought to determine the diagnostic modality and management outcomes of patients with placenta praevia in our centre.

Materials And Method: A retrospective survey of all patients diagnosed with placenta praevia between January 2007 to December 2014 was undertaken. The case records of the patients were obtained from the hospital Medical Records Department.

Results: The incidence of placenta praevia in this study was 1.1%. Majority (74.6%) of the patients were booked. The peak age group was 31-40 years which accounted for slightly more than half (51.6%) of the cases. Many (57.1%) were of low parity (1-2). More than half (69.1%) were delivered at term. Most (96.0%) presented with antepartum haemorrhage. Also, most (81.0%) had major degree placenta praevia. Uterine evacuation was the commonest documented risk factor. More than half (58.7%) were managed expectantly. Majority (95.2%) were delivered by caesarean section. About 42% were transfused with blood. Postpartum anaemia was the commonest (21.0%) maternal morbidity. There was no maternal death. About 12.0% of the babies had birth asphyxia while 31.0% of the babies were of low birth weight. There were seven perinatal deaths (5.3%).

Conclusion: Only an insignificant proportion of these patients were diagnosed as asymptomatic cases during ultrasound scan for other indications. A policy of routine ultrasound scanning is recommended to enhance early diagnosis and improve fetomaternal outcome.

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