Burden of Placenta Previa as a Cause of Postpartum Hysterectomy at a Tertiary Care Hospital

Abstract

Objective: To find the frequency of placenta previa in females undergoing hysterectomy during cesarean delivery at term.

Material and methods: This Cross sectional study was conducted at Department of Obstetrics & Gynecology, Lady Willingdon Hospital, Lahore for 6 months. Total 90 females who will fulfill selection criteria were enrolled in the study from operation theatre. Informed consent was obtained. Demographic features was obtained. Then females undergone cesarean section and planned hysterectomy. All surgeries were done by researcher herself. The location of placenta was noted ultrasound before cesarean and placenta previa was labeled if present. Location of placenta previa was also confirmed during cesarean section.

Results: There were total 90 patients in our study among them the mean age was 36.61±4.31 years. There were 60(66.7%) women who underwent caesarean section previously. There were 12(13.3%) women with placenta previa. Frequency of placenta previa in different age groups was 41.7% in 30-34 years, 25% in 35-39 and 33.3% in women whose age was >40 years. (p- value=0.71). No statistically significant association was seen between gestational age of women and placenta previa. i.e. (p-value-0.106) Gestational age 37-38: 25% (3/12) & Gestational age 39-40: 75% (9/12). Statistically significant association was seen between parity status of women and placenta previa. i.e. (p-value-0.000) Parity-1: 0(0%), Parity-2: 0(0%), Parity-3:5(41.7%) and Parity-4:7(58.3%). No statistically significant association was seen between previous cesarean section of women and placenta previa. i.e. (p-value-0.366) No previous CS: 25% (3/12), One previous CS: 33.3% (4/12), Two previous CS: 16.7% (2/12) & Three previous CS: 25% (3/12).

Conclusion: High frequency of placenta previa was noted in our study among females undergoing postpartum hysterectomy. Keeping in mind the results of this study it can be concluded that the placenta previa being a risk factor for emergency obstetrics hysterectomy should be identified and screened antenatally to improve disease prognosis to achieve desired clinical outcomes.