Evaluation of the risk factors for cases of Placenta Previa with Antepartum Hemorrhage in third trimester: A Retrospective Cross-Sectional study at a tertiary care centre in South India

Abstract

Background and Aim: Severe bleeding linked to placenta previa poses significant risks for maternal health, leading to increased morbidity and mortality rates. Identifying the determinants of severe bleeding in placenta previa during the antenatal period can help pinpoint mothers who are at risk. The current study aimed to investigate the prevalence of recognized risk factors and complications associated with placenta previa.
Material and Methods: A retrospective observational study was conducted at the Department of Obstetrics and Gynecology at Belagavi Institute of Medical Sciences, Belagavi over a period of 2 years from 0ctober 2022 to September 2024. This study involved 73 patients, focusing on the population demographics, which included female patients aged
18 to 44 years. The baseline characteristics and perinatal outcomes of individuals experiencing persistent placenta previa at the time of delivery were analyzed and the prevalence of risk factors were studied.
Results: Incidence of placenta previa was 0.5% of all deliveries in the study period. The study observed maternal ages spanning from 18 to 44 years. The most prevalent age group was 21-25years, comprising 44% of the cases, while 27% fell within the 26-29 years age range. The socioeconomic status of the study participants revealed that 40 individuals, accounting for 56%, originated from low-income families, while 33 individuals, representing 44%, came from lower-middle-income families. There was 1 mortality amongst the cases studied. 70% cases had one or more risk factors like previous cesaren section, previous abortion, teenage or advanced maternal age, third or higher gravida, multiple pregnancy and anemia etc.
Conclusion: previous cesarean sections, previous abortions with history of curettage, teenage pregnancy, increased age at pregnancy, and anaemia are risk factors for placenta previa. While developed nations report a maternal mortality rate of zero for placenta previa, the situation remains concerning in many developing countries, where the rate is still between 1-2%. Individuals diagnosed with placenta praevia are classified as high risk, necessitating the availability of compatible blood prior to the decision to proceed with a caesarean section. Patients with low lying placenta in midtrimester scan and having risk factors for placenta previa should be reffered at the earliest to higher care centres with 24 hours availability of Senior Gynaecologists, Anaesthetists, Pediatrician, blood availability, NICU and ICU care for better management and favourable maternal and perinatal outcomes of such high risk pregnancies.