University of Khartoum

Risk factors, maternal complications and neonatal outcome of major placenta praevia

Risk factors, maternal complications and neonatal outcome of major placenta praevia

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Title: Risk factors, maternal complications and neonatal outcome of major placenta praevia
Author: Gamal A. Elgani Ahmed Gerais
Abstract: This is a prospective, descriptive study conducted among two different groups of patients in two different countries. The first group was carried at AKMICH in K.S.A during the period between June 1999 to July 2003. The second group was at three big hospitals in Khartoum State (SUH, KTH, OMH) in the period between January 2005 to August 2005. The aim of the study was to assess the risk factors of PP, maternal complications and neonatal outcome and to perform a comparison between the two groups of the study. In the first group of the study the incidence of PP and PA were 5 in 1000 and 0.5 in 1000 pregnancies respectively, while in the second group the incidence were 2.8 per 1000 pregnancies and 0.3 per 1000. An association between PP and high parity was found in both studied (P = 0.006 in the first group and P = 0.000 in the second group). Also the incidence of PP was directly proportional to the maternal age in the first and second groups (P = 0.001, and P = 0.004 respectively). Previous C/S was found to be a risk factor for PP in the second group (P = 0.038), while high percentage of the first group had previous one or more C/S (48.4%). In both groups there was high rate of maternal complications. In the first group obstetric haemorrhage (32.8%), caesarean hysterectomy (6.3%), BT (32.8%), hemoglobin less than 10 gm/dl (53.1%), prolonged hospital stay (mean 6.52 ± 1.76 days). In the second group the rate was 63.5%, 13.5%, and 61.5% and mean was 10.0 ± 1.12 respectively. There was one maternal death in the second group (1.9%), while in the first group no maternal death was found. In both studies PP was associated with adverse perinatal outcome. In the first group there was a significantly higher rates of prematurity, admission to SCBU, NICU, Apgar score less than 7 in 5 minutes (P = 0.000; P = 0.001 and P = 0.001) respectively. There was no significant difference in perinatal mortality in this group (P = 0.089). The second group also showed significantly higher rates of prematurity, admission to SCBU, NICU, Apgar score <7 at 5 minutes and increased perinatal mortality (P = 0.000; P = 0.000; P = 0.007 and P = 0.000) respectively. The study concluded that PP is associated with adverse maternal and neonatal outcome. Increased maternal age, high parity and previous C/S were risk factors.
Description: 95 Pages
URI: http://khartoumspace.uofk.edu/handle/123456789/8577
Date: 2015-04-08


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