Placenta Praevia: Incidence, Risk Factors, Maternal and Fetal Outcomes in a Nigerian Teaching Hospital
Background: Placenta praevia is a major cause of antepartum haemorrhage and is potentially life threatening to both the mother and the fetus. This study sought to determine the magnitude of the condition, its risk factors, maternal and fetal outcomes in a tertiary health centre in Jos, Nigeria.
Materials and Methods: A prospective cross-sectional study conducted in all women diagnosed with placenta praevia that spanned over a three and half-year periods (January 2006-June 2009) in Jos University Teaching Hospital, Jos. The patients were followed up until discharged from the hospital. Relevant information was obtained from each patient using a pre-designed study case report form. Statistical analysis was performed using simple percentages.
Results: During the study period, there were 10,895 deliveries and 135 cases of placenta praevia, thus an incidence of 1.24% or 1 in 81 deliveries. The average age of the patients was 30.2 years and majority of them were multi-parous (63.7%). The identified risk factors included previous caesarean section, grandmultiparity, previous uterine evacuation of retained products of conception, multiple pregnancy and history of placenta praevia. Maternal complications included post-partum anaemia, postpartum haemorrhage & operative site infection. There were two maternal deaths (1.48%) and the perinatal mortality rate was 18.7%.
Conclusion: The incidence of Placenta praevia was relatively high and associated with high maternal and perinatal complications. Screening ultrasonography in women with history of multiple caesarean sections in the third trimester and timely delivery may help to reduce the maternal and perinatal morbidity and mortality associated with placenta praevia.