Placenta praevia: epidemiology and management at the University Teaching Hospital (CHU) Yaounde

Abstract

The aim of the study was to define the epidemiological profile of patients with placenta praevia and evaluate the surgical management at the University Teaching Hospital (CHU) Yaounde. It is a retrospective review of all cases of delivery between January 2000 and December 2003 to identify all cases of placenta praevia who had caesarean delivery. Placenta praevia as used in our study was restricted to cases of caesarean delivery for placenta praevia. Among the 7538 deliveries, there were 88 cases of placenta praevia, which gave an overall incidence of 1.2%. The mean age was 30 ± 6 years and the mean parity was 2.4 ± 2.2. The mean gestational age at delivery was 36 ± 3.3 weeks. The risk factors of placenta praevia in these patients included uterine myoma (20.3%), history of previous placenta praevia (1.4%), history of previous caesarean section (9.5%), history of myomectomy (1.4%), twin pregnancy (1.4%) and abortions (45.9%). Symptoms were dominated by vaginal bleeding (96.0%). ‘Double setup' was carried out in 5.4% of cases. In 93.2% of cases it was an emergency caesarean section. The correlation between the third trimester transabdominal ultrasound and surgical findings on the type of placenta praevia was 0.679 (p < 0.001). Maternal morbidity was dominated by anemia (75.7%), and no case of maternal death was recorded. The perinatal mortality rate was 10.8%. We conclude that the incidence of placenta praevia in the University Teaching Hospital is high. Properly timed emergency caesarean delivery is a major strategy to reduce maternal and perinatal morbidity and mortality. Further studies are warranted to document the risk factors of placenta praevia in Cameroon.

Keywords: placenta praevia, incidence, perinatal mortality

Clinics in Mother and Child Health Vol. 1(2) 2004: 79-84