Niger Delta Medial Journal

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THE RETROSPECTIVE AUDIT OF CLINICAL PRESENTATION AND OBSTETRIC OUTCOMES OF PREGNANCIES COMPLICATED BY PLACENTA PREVIA: A FIVE-YEAR REVIEW IN THE NIGER DELTA

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Authors
Abednigo O. Addah, Ninabai N. Ofuruma, Isa A. Ibrahim
1 Department of Obstetrics and Gynaecology
Niger Delta University Teaching Hospital. Okolobiri, Bayelsa State, Nigeria
0000-0001-5019-6687
2 Department of Obstetrics and Gynaecology
Niger Delta University Teaching Hospital. Okolobiri, Bayelsa State, Nigeria
0000-0004-3274-2212
Corresponding Author
Dr Abednego O Addah
Department of Obstetrics and Gynaecology
Niger Delta University Teaching Hospital. Okolobiri, Bayelsa State, Nigeria
Email: draddah@yahoo.com
0000-0001-5019-6687

 

ABSTRACT
Background.
Placenta previa is a significant source of anxiety for Obstetricians because of the difficulties associated with its management: The placenta previa is the term used when the placenta is sited in the lower uterine segment, wholly or partially covering the internal os. At term when the cervix begins to efface and dilate in preparation for labor, the placenta dethatches from its attachments thereby provoking massive obstetric
hemorrhage, warranting a cesarean delivery (CS). The objective of this study was to audit the management of pregnancies complicated by placenta previa and their outcomes including morbidity and mortality at the Niger Delta University Teaching Hospital Okolobiri over a period of five years.

Methodology
This study was a retrospective analysis of all women whose pregnancies were complicated with placenta previa and was delivered at the Niger Delta University Teaching Hospital, Okolobiri Nigeria from January st, st, 1 2016 to December 31 2020. Relevant information was extracted from patient folders using a proforma including sociodemographic factors and other relevant factors such as, age, marital status, parity,
gestational age at delivery, mode of delivery, blood loss at delivery, the hierarchy of the Surgeon and others. The Data obtained were analyzed using SPSS statistical software Version 25
Results.
There were 1,876 deliveries during the study period, 661 patients had Caesarea sections of whom 35 of them had placenta previa, giving a hospital prevalence of placenta previa to be 1.9 %. Placenta previa was accidentally diagnosed in 47.1 % of patients. Type 3 placenta Previa (40.8%) was the most common variety. Emergency CS constituted 55.6%, and elective Cesarean made up 44.4% of cases. The most common risk factors identified in the study were the previous termination of pregnancies by dilatation and curettage which made up 29.1% of patients; previous CS and multiparty were found in 24.6% each of the study population.

Conclusion. Obstetricians should srtive to save maternal life in the dire emergencies of placenta previa. Care givers should use every tool at their disposal to nurture the fetus to a gestational age of independent survival at birth.