Maternal Risk Factors & Perinatal Outcomes in Women with Placenta Previa: A Cross Sectional Study

Zanwer Sabir Mahmood, A. Jawad
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Abstract

Background and objectives: Placenta previa is one of the main factors in adverse maternal and neonatal outcomes. This study was conducted to determine risk factors for placenta previa and subsequent maternal and perinatal outcomes. Methods: This cross sectional study was conducted at Maternity Teaching Hospital, Erbil City, Kurdistan region, Iraq, from August 2020 to August 2021. Sixty Patients with placenta previa who presented with antepartum hemorrhage after 24 weeks of gestational age were included in the study. Participants underwent complete obstetrical and clinical assessment including history of risk factors, general physical, abdominal and pelvic examinations. Imaging methods used included transabdominal and transvaginal ultrasound. Patients were managed according to maternal and fetal conditions, and any maternal and fetal complications were recorded. Results: previous history of placenta previa was observed in 16.7% and previous cesarean section in 60% of women. Maternal outcome was good in majority (91.7%) of cases. Hysterectomy was performed on two women (3.3%). Emergency caesarean section was performed on 58.3% of women, and elective caesarean section was performed on 36.7% of women and neonatal death rate was 66.7% among those delivered by spontaneous vaginal delivery. Greater gestational age, lesser neonatal death rate. Women with grade IV placenta previa had worse neonatal and maternal outcomes than women with lower grades of placenta previa. Conclusion: A higher incidence of placenta previa is seen in patients with previous cesarean section, advanced maternal age, and high parity. No significant association was detected between neonatal outcomes and maternal risk factors.
前置胎盘妇女的产妇风险因素与围产期结果:横断面研究
背景和目的:前置胎盘是孕产妇和新生儿不良结局的主要因素之一。本研究旨在确定前置胎盘的危险因素以及随后的孕产妇和围产期结局。方法:本横断面研究于2020年8月至2021年8月在伊拉克库尔德斯坦地区埃尔比勒市妇产教学医院进行。60例在孕24周后出现产前出血的前置胎盘患者被纳入研究。参与者接受了完整的产科和临床评估,包括危险因素史、一般体格、腹部和骨盆检查。成像方法包括经腹和经阴道超声。根据产妇和胎儿情况对患者进行管理,并记录任何产妇和胎儿并发症。结果:16.7%有前置胎盘病史,60%有剖宫产史。绝大多数(91.7%)产妇结局良好。子宫切除术2例(3.3%)。58.3%的妇女接受了紧急剖宫产,36.7%的妇女接受了选择性剖宫产,自然阴道分娩的新生儿死亡率为66.7%。胎龄越大,新生儿死亡率越低。IV级前置胎盘的妇女比低级别前置胎盘的妇女有更差的新生儿和产妇结局。结论:有剖宫产史、高龄、高胎次者易发生前置胎盘。未发现新生儿结局与产妇危险因素之间存在显著关联。
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