Placenta Praevia: A Study of Risk Factors, Maternal and Fetal Outcome

Abstract

Context: With the availability of ultrasound scan, most placenta praevia are detected before symptoms occur. However in most hospitals in Nigeria these facilities are not available and early detection of this condition is still not possible. Majority is diagnosed when symptoms occur. The only useful method of early diagnosis is the use of markers for this condition and early referral to centers were definitive diagnosis can be made.

Objective: To determine the risk factors for placenta praevia in our environment and the associated morbidity and mortality.

Methods: A hybrid, case control and descriptive study of all cases of placenta praevia seen at the Havana Specialist Hospital, Lagos, Nigeria over a period of 3 years (May 2000 April 2003)

Results: The incidence of placenta praevia placenta praevia was 2.6% with 51.3% of cases being asymptomatic and 33.3% presenting as emergency. Some 59.0% were of minor degree. Majority of patients were delivered at between 34 and 38 weeks. No maternal death occurred, but the perinatal mortality rate was 76.9 per 1000 births. On univariate analysis, multiparity, advanced age, previous placenta praevia, caesarean section and early pregnancy bleeding were significantly associated with placenta praevia. However after multiple logistic regression, only early pregnancy bleeding and previous caesarean section retained their significant association with placenta praevia.

Conclusion: With previous caesarean section and early pregnant bleeding identified as predictors of placenta praevia, early referral to center equipped with scan will not only confirm the diagnosis but will facilitate early and prompt management.

Key Words: Placenta Praevia, Antepartum Haemorrhage

[Trop J Obstet Gynaecol, 2004;21:131-134]