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Placenta praevia at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. A ten year analysis.

CONTEXT
Placenta preavia is one of the obstetric emergencies associated with maternal mortality and morbidity. It is also a major cause ofprematurity. With prompt and appropriate management the complication can be drastically reduced.


OBJECTIVE
The objective of this study is to document the pattern of presentation, mode of management and the outcome of the management of placenta praevia at Obafemi Awolowo Teaching Hospitals Complex (I.H.U.), Ile-Ife between January, 1996 to December, 2005. The outcome will help in identifying the women at risk and offer suggestions to reduce the associated complications.


MATERIALS AND METHODS
The study involved a ten-year retrospective analysis of the data collected from the case records of all the cases diagnosed as having placenta praevia during the period under review.


RESULTS
During this period there were 7515 deliveries and a total of 128 cases of placenta praevia giving an incidence of 1.65% i.e. 3 in 200 births. Majority (58.2%) of patients with placenta praevia were unbooked and 77.4% of them were multiparous. Only 20.2% were accessible for diagnosis by ultrasound scanning, while 25.8% of them were delivered before 36 weeks of gestation. The perinatal mortality rate was 177 per 1000 births.


CONCLUSION
Placenta praevia is still a major cause of obstetric morbidity and mortality. The diagnosis can be made with routine ultrasound scanning which then allows patient identification and institution of appropriate and comprehensive treatment aimed at minimizing complications. The role of good referral system, 24 hours blood banking services and facilities for caesarean section and adequate neonatal backup in preventing morbidity and mortality associated with the condition can not be over emphasized.