Aim: analysis of maternal and fetal outcome in pregnancy complicated with placenta previa and to evaluate the potential risk factors

Methods: 50 pregnancies with placenta previa during a 2 years study period (2014-2016) were analyzed. The total number of deliveries duringthe study period was 4759. The data on the potential risk factors compiled; the information on the maternal and neonatal outcome was subjected to appropriate statistical analysis and following deductions provided

Result: The incidence of placenta previa was 1.8%. Factors significantly

associated with development of placenta previa were advanced maternal age, number of previous cesarean section, number of previous abortions and multiparity The complications seen most commonly in the neonatal outcome was prematurity at birth (42.85%) followed by RDS (28.5%) and aspiration (14.2%). 48% of the babies required resuscitation, out of which 24% required further NICU admission. The neonatal mortality calculated was 280/ 1000 live births.


Conclusion: Inspite of 24 hours emergency services being available, and ear1y diagnosis being at hand, lots more is required to bring down the maternal morbidity and neonatal mortality and morbidity to international standard for us to do justice to the patients.


Placenta previa; maternal morbidity; Neonatal mortality.

Full Text:



Razia Mehboob, Nazir Ahmed. Maternal and fetal outcome in placenta previa. Pakistan J Med. Res. 2003; 42(1).

Emily Olive, Christing L, Robert S, Charles S, Albert and Jonathan MM. Placenta previa: Maternal morbidity and place of birth. Auz & NZ 3 of Obstet & Gynecol. 2005; 45(6): 499-504.

Gorodeski IG, Bahari CM. The effect of placenta previa localization upon maternal and neonatal outcome. International Journal of Perinatology. 1987; 15: 169-77.

Bhide A, Prefumo F, Moore J et al. Placental edge to internal os distance in late trimester and mode of delivery in placenta previa. Br J Obstet & Gyn India. 2003; 39: 517.

Erin L Butler, Jodi S, Dashe, Ronald MR. Association between MSAF and adverse outcome in pregnancy with placenta previa. 3 Obstet & Gynecol. 2001; 97(1): 37-38.

Harvey A, Gabert. Correlation between placenta previa and fetal growth. Am 3 Obstet & Gynecol. 1971; 38: 403-406.

McShane PM, Heyl PS, Epstein MF. Maternal and perinatal morbidity resulting from placentaprevia. 3 Obstet & Gynecol. 1985; 65:176-182.

Tariq Khasbhoggi, Arab Board. Correlation of placenta previa with maternal and neonatal outcome. Ann Saudi Med. 1995; 15(4).

Taylor YM, Peacock S, Kramer TL Vaughan. Placenta previa in Asian origin women: Incidence & Outcome. Intl J Obstet & Gynecol. 1995; 86: 805-808.

Edward T Way, Angie Mallozzi, Toan F. Rodis, James FX, Egan Antohny M, Vintzilios, Winster AC. Association of baby weight with gestational age in placenta previa. Intl J Obstet & Gynec. 1996; 90: 120-128.

Ananth CV, Wilcox AJ, Savintz DA, Boes WAT. Relationship between PIH and placenta previa and risk of placenta previa with LSCS, sex of the offspring and smoking. Am 3 Obstet & Gynecol. 1997.

Joan MG, Crane Michel C, Van D, Linda D, Anthony A, Robert L. Neonatal outcome in placenta previa. Am J Obstet & Gynecol. 1999; 93: 541-544.

Buttler, Erim, Dashe, Ramus, Ronald. Association between maternal serum alfa-feto protein and adverse outcome in pregnancy with placenta previa. Intl 3 Obstet & Gynecol. 2001; 97(1): 35-38.

Sheiner E, Shoham-Vardi I, Hallak M, Hershkowitz R, Katz M, Mazor M. Placenta previa: Obstetric risk factor and pregnancy outcome. 3 Maternal & Fetal Medicine. 2001; 10(61): 414-419.

Gillian, Melessa, Rosenberg, Deberan. Association of placenta previa with higher number of previous LSCS and parity. Intl J Obstet & Gynecol. 2002; 99(6): 976-980.

Ananth CV, Mullian S, John C, Vintzileus Anthony M. Association of placenta previa with prematurity and growth restriction and neonatal mortality. Am J Obstet & Gynecol. 2003; 188(5): 1299-1304.

Tuzovic L, Djelmis J, Illijic M. Obstetric risk factors in placenta previa. Croat Med J. 2003; 44: 727-733.

Handler AS, Mason ED, Rosenberg DL. Relationship between exposure during pregnancy to cigarette smoking and cocaine use and placenta previa. Am J Obstet & Gynecol. 1994; 170: 884.

Sharma AS, Gupta VI. Tocolytic therapy in conservative management of symptomatic placenta previa. Intl J of Obstet & Gynecol. 2004; 84(2):. 109-13.

Jackson RA, Gibson KA, Wu YW, Croughan MS. Perinatal outcomes in singletons following in vitro fertilization: A meta-analysis. Intl J Obstet & Gynecol. 2004 Mar; 103 (31): 55 1-63.

Emily C Olive, Christine L, Roberts Charles 5, Algert & Jonatha MM. Placenta previa: Maternal morbidity and place of birth. Aus & NZ J Obstet & Gynecol. 2005; 45(6): 499-504.

Richard LN. Abruptio & placenta previa frequency, perinatal outcome and cigarette smoking. Intl J Obstet & Gynecol. 2005; 106(5): 986-991.

Oyeue, Yinka, Smiltian J. Placenta previa, placenta accreta, vasa previa. Intl J Obstet & Gynecol. 2006; 107(9): 927-941.

Ananth CV, WiloxAJ, Cavitz DA, Bowes WA Jr, Luther ER. Effect of maternal age and parity on risk of uteroplacental bleeding in pregnancy. Intl J Obstet & Gynecol. 2006; 2: 511-6.

Allen VM, Wilson RP, Cheung A. Pregnancy outcome after assisted reproductive technology. Reproductive Endocrinology Infertility Committee (SOGC). Intl J Obstet & Gynecol. Canada. 2006; 28(3): 220-250.

Jaswal A, Manaktala U, Sharma JB. Cervical encirclage in expectant management of placenta previa. Intl J Obstet & Gynecol. 2006; 93(1): 51-2.

Gobman, William, Gorshovez, Landon, Mark, Sporg et al. Correlation of number of previous LSCS and placenta previa. Intl J Obstet & Gynecol. 2007; 110(6): 1249-1255.

.Qiuying Yang, Shi Wu, Yen, Sharon Caugh EY, Daniel, Krewski, Lumingsum, Mark C Walker. Placenta previa: Its relationship with race and the country of origin among Asian Women. Acta Obstetrica & Gynecologica Scandinavica. 2008; 87(6): 612- 616.

Savita Rni, Singhal, Nymphaea, Smitinanda. Maternal and perinatal outcome in APH. Intl J Obstet & Gynecol. 2008; 9(2).

Konje JE, Raylor DJ. Bleeding in pregnancy. In James DK, Steer PJ, Weiner CP, Gonik B, editors. High risk pregnancy management options. 2m1 ed. London: Harcourt 2000.

Dutta DC. Antepartum hemorrhage. In: Konar HL editor. Textbook of Obtetrics. 6th ed. New Central Book Agency, Kolkatta 2006: 243-46.

Neilson JP. Antepartum hemorrhage. In: Edmonds DK editor. Dewhursts Textbook of Obstetrics & Gynecology for postgraduates. 6th ed. Blackwell Scientific London, Oxford 1995: 164-74.

Arora R, Devi U, Majumdar R. Perinatal morbidity and mortality in antepartum hemorrhage. J Obstet Gynec India. 2001; 51(3): 102-4.

Das B. Antepartum hemorrhage in three decades. J Obstet Gynec India. 1975; 25: 636-7.

Motwani MN, Sheth J, Narvekar NM, Pundare MC, Hansotia MD. Maternal mortality resulting from antepartum hemorrhage — Review of 20 years. 3 Obstet Gynecol India. 1989; 39: 364-6.

Khosla A, Dahiya V, Sangwan K, Rathore S. Perinatal outcome in antepartum hemorrhage. J Obstet Gynecol India. 1989; 9: 7 1-3.

Krohn M, Voigt L, McKnight B, Doling JR, Starzyk P, Benedetti TJ. Correlates of placenta abruption. Br J Obstet Gynecol. 1987; 94: 333-40.

Demissie K, Brekenridgen MB, Joseph L, Rhoads GG. Placenta previa: Preponderance of male sex at birth. Am 3 Epidemiol. 1999; 149: 824-30.

Macafee CGH. Placenta previa — study of 174 cases. J Obstet Gynecol Br Emp. 1945; 52: 313.

Dommisse J. Placenta previa and intra-uterine growth retardation. S Afr Med J. 1965; 67: 291-2.

Spinillo A, Fazzi B, Stronati M, Ometto A, Capuzzo E, Guaschino S. Early morbidity and neurodevelopmental outcome in low-birthweight infants born after third trimester bleeding. Am J Perinatol. 1994; 11:85-90.

Crowley P. Corticosteroids prior to preterm delivery. In: Enkin MW, Keirse MJNC, Renfrew MJ, Neilson JP eds. Pregnancy and childbirth module, “Cochrane Database of Systematic Reviews”, Review No. 02955, August 14; 1994. Disk Issue 1, Oxford Update Software, 1994.

Merciere CE, Soll RF. Clinical trials of natural surfactant extract in respiratory distress syndrome. ClinPerinatol. 1993; 20L 711-35.

Ratnam SS et al. Obstetrics & Gynecology for Postgraduates. 2’ edition India. Orient Longman. 2007; 78-88.

Fernando Arias. Practical guide to high-risk pregnancy and delivery.3rd edn., USA, Elsevier. 2008: 333-342.

Saunder’s High Risk Pregnancy Management Options. 3rd edn. London. WB Saunders. 2000: Chapter-8: 111-117.

Oxorm Foote’s Human Labour& Birth. 5th edn., USAQ McGraw Hill. 2000: 19,20, 499-503.

Mudlair and Menon’s Clinical Obstetrics. 10th Edn., India. Orient Longman. 2006: 165-168.

Barret 3 et a!. Induced abortion — A risk factor for placenta previa. Am JObstetGynec. 1981; 141: 769-772.

Brenner W et al. Characteristics of patients with placenta previa and results of expectant management. Am J Obstet Gynec. 1978; 132: 180-189.

Campbell S. Ultrasound in obstetrics and Gynecology, 1992.

Chervanak F et al. 1984. Role of attempted vaginal delivery in the management of placenta previa Obstet & Gynecol 1984, 64: 798-801

Cotton D et al The conservative aggressive management of placenta previa Am J Obstet Gynecol 1980, 137 687-695

D’Angelo et al. Conservative management of placenta previa. A cost benefit analysis. Am J Obstet Gynecol. 1983; 149: 320-326.

FanneD et al. Vaginal USG for diagnosis of placenta previa. Am J Obstet Gynec. 1988; 159: 566-569.

George Macones et al. Association between maternal cocaine use and placenta previa. Am J Obstet Gynecol. 1997; 177: 1097-1100.

Gofferfeld K et al. Ultrasonic placentography: A new method for placental localization. Am J Obstet Gynecol. 1966; 96: 538-547.

Grimes D et al. Legal abortion and placenta previa. Am J Obstet Gynecol. 1984; 149: 501-504.

Hemmadi et al. Recent trends in the management of placenta previa. md 3 Obstet Gynecol. 1989; 39(71): 365-368.

Ian Donald: Textbook of practical obstetric problems. Fifth Edition, pp. 423-454.

lyasu et al. Epidemiology of placenta previa in the United States. Am J Obstet Gynecol. 1993; 168: 1424-9.

James Comearin et al. Early placenta previa and delivery outcome. Obstet Gynecol. 1983; 61: 577.

Laverty PL. Placenta previa. Clinics of Obstet & Gynecol. 1990; 33: 414-421.

Leerenvelt et al. Accuracy and safety of TVS localization of placenta. Obstet Gynecol. 1990; 76: 759-762.

Mabie WC. Placenta previa. Clinical Perinatology. 1992; 19: 425- 435.

McClure et al. Early identification of placenta previa. Br J Obstet Gynecol. 1988; 159: 566-569.

Michelle A Williams Ct al. Increasing maternal age as a determinant of placenta previa. 3 of Rep Med. 1993; 38(6): 425-428.

Myerscough PR. Munrokerr’s operative obstetrics. 10th Edn., 1982.

Newton E et al. The epidemiology and clinical history of asymptomatic mid-trimester placenta previa. Am J Obstet Gynecol. 1984; 149: 743-746.

Patricia M McShane et al. Maternal and perinatal morbidity resulting from placenta previa. Obstetrics Gynecology. 1985; 65 (2) 176-182. V

Richard Naeye. Abruptio placentae and placenta previa frequency, perinatal mortality and cigarette smoking. Obstet Gynecol. 1980; 55(6); 701-704.

Reddi P Rani et al. Placenta previa — An analysis of 4 year experience. Indian J of Obstet Gynecol. 1999; 19(3): 53-55.

Rose GL et al. Etiological factors in placenta previa a case controlled study. Br J Obstet Gynecol. 1986; 93: 586-588.

Sand H. Ultrasonic diagnosis of placenta previa. ActaObstetGynecolSuppi. 1997; 56: 105-108.

Silver et al. Placenta previa aggressive expectant management. Am J Obstet Gynecol. 1984; 156: 15-21.

Singh P et al. Placenta previa and prior cesarean section. Acta Obstet Gynecol. 1981; 60: 367-368.

Steven Clark et al. Placenta previa! Accreta and prior cesarean section. Obstet Gynecol 1985; 66: 89.

Strong T Ct, al. Placenta previa in twin gestation. J of Rep Med. 1989; 34: 415-416.

Studd. Progress in obstetrics and gynecology. Vol. 11, pp. 161-178.

Timor Trisch et al. confirming the safety of TVS in patients suspected of placenta previa. Am J Obstet Gynecol. 1986; 154: 565-569.

Varma T. The implication of a low implantation of placenta detected by USG in early pregnancy. Acta Obstet Gynecol Scand. 198 l;60: 265-268.

Victoria Taylor et al. Placenta previa and prior cesarean delivery — How strong is the association. Obstet Gynecol. 1994; 84: 55-7.

Victoria Taylor et al. Placenta previa in relation in induced and spontaneous abortion — A population based study. Obstet Gynecol 1993; 82: 88-91.

Williams M. Cigarette smoking in pregnancy in relation to placenta previa. Am J Obstet & Gynecol. 1991; 165: 28-32.

Wolf E et al. Placenta previa is not an independent risk factor for a small for gestational age infant. Obstet Gynecol. 1991; 77: 707-709.

Zhang J et al. Maternal age and placenta previa — A population based study. Am J Obstet Gynecol. 1993; 168: 641-645.

Williams Textbook of Obstetrics, 22’’ Edn. USA, McGrawhill. 2005: 819-823.

Tumbulls, Obstetrics. 3fl edition. Edinburgh. Churchill Livingstone, Elsevier. 2004: Chapter-14: 2 14-220.


  • There are currently no refbacks.