Patient Characteristics and feto-maternal Outcomes Among Cases Of Placenta Previa and Accidental Hemorrhage

Document Type : Original Article

Author

The Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt

Abstract

Introduction: Third trimester bleeding is one of the major
obstetric emergencies, which contribute greatly to maternal
and fetal morbidity and mortality. It is defined as bleeding from or into the genital tract prior to delivery of the
baby anytime from 20 weeks gestation, in some developed
countries or 24 weeks gestation, in others or 28 weeks in
countries with low resource settings thus lacking adequate
neonatal support incubators.
The aim of this study: The study aimed to elucidate the
outcomes with the associated morbidities, which will help < br />define the magnitude of the problem posed by antepartum
hemorrhage in order to better the management measures
available to promptly tackle and alleviate this condition.
Patients & Methods: This study was prospective observational study conducted in Department of Obstetrics and
Gynecology, Faculty of Medicine, Fayoum University
Hospital and El-Sahel Teaching Hospital. All cases of antepartum hemorrhage admitted to emergency unit at maternity hospital after the age of 28 week of gestation during the
period from (1st of August 2019 to end of November 2020)
were included in this study, meeting the inclusion and exclusion criterion.
Results: Total number of patients who were admitted to
obstetric department with APH during the study period was
120 case of them 25 cases were elective and all of them
were placenta previa cases and 95 cases were emergency.
67 cases (55.83%) with placenta previa (25 elective and 42
emergency) & 44 (36.636%) with accidental hemorrhage
(all are emergency or urgent cases), 9 (7.5%) due to other
causes. Maternal outcome in PP include Increased numbers
of CS 67 case (100%), Increased number of units of blood
transfusion (1-18) unit with mean 4.31 ± 3.27, Hysterectomy 21 case (31.3 %), Shock 29 case (43.3 %), Urinary injury either bladder or ureteric injury 5 cases (7.5 %) (4cases bladder injury and 1 case Ureteric injury) all of them
were placenta percreta, ICU admission 14 case (20.9 %),
postpartum hemorrhage occurred in 6 cases and maternal
mortality one case (1.5%). While maternal out come in accidental hemorrhage patients was numbers of CS delivery was 35 cases and 9 cases delivered vaginally,
number of units of blood transfusion (1-18)
unit with mean 3.57 ± 3.08, Hysterectomy 3
cases (6.8%), Shock 22 case (50%),Conclusion Previous CS was found to be the most
important risk factor for Placenta praevia
and accreta Pre-eclampsia& previous abruption were the most important risk factors for
abruption. Fetal morbidities associated with
both placenta previa & abruption were prematurity, low birth weight, low Apgar score,
admission to NICU.


Keywords