Risk Factors and Feto-Maternal Outcomes of Placenta Previa in Un-Scarred Patients at Liaquat University Hospital Hyderabad Sindh

Objective: To determine, frequency, risk factors of maternal and fetal morbidity and mortality in women with placenta previa in un-scared pregnant women. Methodology: This prospective observational study was conducted in the Obstetrics and Gynecology Unit-I at Liaquat University Hospital, Hyderabad, from June 16, 2021, to January 16, 2022. It included unscarred pregnant women with placenta previa beyond 24 weeks of gestation, with singleton pregnancies, and those presenting with antepartum hemorrhage due to placenta previa who were willing to participate. Data were collected on maternal factors such as age, gestational age, parity, clinical features, obstetric history, timing of placenta previa diagnosis, duration of hospital stay, need for blood transfusion, mode of delivery, and any surgical interventions required to control bleeding. Neonatal outcomes were also recorded, including gestational age at birth, birth weight, APGAR scores, stillbirths, NICU admissions, and neonatal mortality. Data were entered and analyzed using SPSS version-26. Results: Mean maternal age was 31.34 years and mean gestational age of 34.11 weeks. Maternal outcomes revealed 54.7% postpartum hemorrhage (PPH), 41.1% needed hemostatic sutures, and 27.4% required uterine packing or tamponade. Hysterectomy was performed in 13.7% of women, and most women received multiple blood transfusions. Only 2.1% needed ICU care, and one maternal death was reported. Fetal outcomes showed, 24.2% preterm births, 82.1% resulted in low birth weight, and 52.6% of neonates had birth asphyxia. Stillbirths were 6.3%, and 47.4% of newborns required NICU admission. Neonatal mortality during hospitalization was 46.3%. Conclusion: Placenta was observed to be the major cause of adverse fetal and maternal outcome. Previous uterine curettage history, uterine anomalies, and artificial conception were observed to be the causative risk factors.