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Risk factors, maternal and neonatal outcome in major placenta previa: a prospective study.

Bleeding from placenta previa is one of the most acute lifethreatening emergencies in obstetric practice. The potential maternal and neonatal morbidity and mortality associated with this condition have generated a lot of concern among practicing clinicians. Failure to recognize the condition and manage the associated complications particularly the massive obstetric hemorrhage have led to most cases of avoidable maternal deaths. In the confidential inquiries into maternal deaths in the United Kingdom (1994-1996) 50% of deaths due to hemorrhage were related to abruptio placenta and placenta previa of which the danger of bleeding from placenta previa in a scarred uterus was very obvious. Previous cesarean section (CS) scar is a risk factor in the development of placenta previa accreta. Improvements in diagnostic accuracy and enhancement in planned intervention strategies have been brought about by the introduction and use of ultrasonography and magnetic resonance imaging (MRI) in obstetric practice. This study was aimed at determining the incidence the predisposing risk factors and maternal and neonatal effects of major placenta previa in our population. Findings arising from this survey could facilitate establishing a management and preventive protocol with a view to averting possible fatal maternal and neonatal outcomes. (excerpt)