Gayathriedevi Sellathamby, Sathiya Baskaran
BACKGROUND The highest prevalence of placenta praevia internationally is in Asian women. Placenta praevia is found to complicate 0.4% to 0.5% of all pregnancies and is one of the major causes of third trimester haemorrhage which is increasing in incidence due to rise in caesarean delivery rates. This dreaded and devastating complication is the important cause of maternal and perinatal morbidity and mortality in India. METHODS This is a retrospective study conducted in the department of OBG, Mahatma Gandhi Memorial Government Hospital, attached to K. A. P. Viswanatham Medical College, Trichy for a period of one year from January 2018 to December 2018. All cases of placenta praevia during pregnancy admitted in labour ward during this period were included in the study. All case records were obtained from the medical record section, and carefully analysed to find out the incidence, various types of placenta praevia, its clinical presentation, and its outcome in relation to mode of delivery, birth weight, and maternal/perinatal morbidity. RESULTS During the study period, a total of 8734 patients delivered; out of these, 108 patients with placenta praevia were encountered, which makes the prevalence of placenta praevia 1.2% and was more commonly present among multiparous women (73.1%). Out of 108 cases, 70 cases (64.8%) were delivered by caesarean section and 8 cases (7.4%) underwent peripartum hysterectomy. Incidence of placenta praevia in scarred uterus was found to be 76 (70.3%) which was much higher than in unscarred uterus. CONCLUSIONS Incidence of placenta praevia and its associated complications is more in scarred uterus when compared to unscarred uterus. Managing a case of placenta praevia during pregnancy poses a great challenge to every obstetrician in present day obstetrics due its increased risk of maternal and perinatal complications. Reduction in primary Caesarean section rates can significantly reduce the risk of placenta praevia.
