URL of this page:
This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background and Objective. Placenta previa PP is a potential risk factor for obstetric hemorrhage, which is a major cause of fetomaternal morbidity and mortality Placenta previa a case study developing countries. This study aimed to determine frequency, risk factors, and adverse fetomaternal outcomes of placenta previa in Northern Tanzania.
A retrospective cohort study was conducted using maternally-linked data from Kilimanjaro Christian Medical Centre birth registry spanning to All women who gave birth to singleton infants were studied.
A total of 47, singleton deliveries were analyzed. Of these, the frequency of PP was 0. Adverse maternal outcomes were postpartum haemorrhage, antepartum haemorrhage, and Caesarean delivery.
PP increased odds of fetal Malpresentation and early neonatal death. The prevalence of PP was comparable to that found in past research. Multiple independent risk factors were identified. PP was found to have associations with several adverse fetomaternal outcomes.
Early identification of women at risk of PP may help clinicians prevent such complications. Introduction Placenta previa is an obstetric complication characterized by Placenta previa a case study implantation into the lower segment of the uterine wall, covering whole major or part minor of the cervix [ 1 ].
Placenta previa usually presents with painless vaginal bleeding in the late second or early third trimester. It is diagnosed on ultrasound during the second trimester or incidentally during an operation. Obstetric hemorrhage is a leading cause of fetomaternal mortality and morbidity in Sub-Saharan Africa [ 4 ].
Placenta previa has further been linked to maternal hypovolemia, anemia, and long hospital stay, as well as adverse fetal outcomes such as low birth weight, congenital abnormalities, stillbirth, and early neonatal death [ 5 — 9 ].
While the precise etiology of placenta previa is not known, previous studies have elucidated predictive factors such as high maternal age, twin pregnancies, previous Caesarean section, previous uterine scar, grand multiparity, malpresentation, and diabetes mellitus [ 57 — 11 ].
The estimated global prevalence of placenta previa is 5. However, there are no studies in Tanzania which have evaluated the burden of placenta previa and its associated adverse fetomaternal outcomes.
Therefore, this study aimed to determine frequency, risk factors, and adverse fetomaternal outcomes of placenta previa in Northern Tanzania. Understanding these associations would help improve early diagnosis of placenta previa and allow for better management and prevention of adverse outcomes.
It is one of four zonal referral hospitals in the country, serving over 15 million people and performing an annual average of deliveries. The birth registry was established in as collaboration between KCMC and the registry of University of Bergen, Norway, and has been operational since Study Population and Sampling Procedure All singleton deliveries that took place at Obstetrics and Gynecology Department of KCMC hospital from January to December with complete birth registry records were considered for analysis.
Women diagnosed with placenta abruption were excluded to avoid misdiagnosis of placenta previa. In addition, women with multiple gestation pregnancies were also excluded to avoid overrepresentation of studying high risk women.
The final sample was comprised of 47, deliveries which were analyzed. Data Collection Methods and Tools A standardized questionnaire was used to collect information for the medical birth registry.
Each woman who delivered at KCMC was individually consented to interview, after which trained midwives worked through the standardized questionnaire. Women were interviewed daily, within 24 hours of delivery, or as soon as possible after recovery in case the mother had delivery complications.
Information collected included maternal age, occupation, education, marital status, childhood, and present areas of residence; past medical history; last menstrual period and regularity of cycle; history of present and past smoking, drinking, or chewing tobacco use; drug, herb, and medication use; obstetric history, including first ANC visit, number of ANC visits, use of family planning, pregnancy complications, and details of labor; history of previous pregnancies, including miscarriage, stillbirth, preterm birth, fertility treatment, and mode of delivery; and sex, weight, and any medical ailments of the infant most recently delivered.
The recorded information was corroborated with the antenatal cards and written medical records whenever possible. These data were entered into a computerized database system located at medical birth registry, from which they were retrieved for this study.
It is worth noting that all women who deliver for the first time at KCMC are assigned with a unique mother identification number. This number is constant for all births that occur at KCMC.
The same number is available to the child file; this makes it possible to link siblings with their biological mothers for subsequent births. Definition of Terms Placenta previa was defined as an obstetric complication characterized by placental implantation into the lower segment of the uterine wall, covering part of or the entire cervix.
Postpartum hemorrhage was defined as blood loss of mL or more after delivery. Apgar score was defined as a measure of the physical condition of a newborn infant.
The Apgar score has a maximum ten points, with two possible for each of heart rate, muscle tone, response to stimulation, and skin coloration. Mean with respective standard deviation was used to summarize a normally distributed maternal age and frequencies with respective percentages were used to summarize categorical variables.In this case-control study, cases of placenta previa confirmed at delivery (ascertained by International Classification of Diseases, ninth revision, Clinical Modification, code-based search, N.
During pregnancy, the fetus develops in a special fluid that helps to keep it protected. The amniotic fluid also aids in the development of the. Our group has been closely involved in community hospital placental pathology since Dr. Shaw attended Dr.
Doug Shanklin's groundbreaking CME course in Gatlinburg, Tenn. in We have given focused attention to placental pathology since then and consider that we have an actual "placenta program" concerning placenta evaluation for our .
Classically, the clinical presentation of placenta previa is painless vaginal bleeding in the second or third trimester. In contrast, placental abruption, classically presents with painful vaginal bleeding.. Risk Factors: Below is a list of several risk factors that are associated with placenta previa.
Placenta previa is generally defined as the implantation of the placenta over or near the internal os of the cervix. There are four types of placenta previa; total, low-lying, partial, and marginal. The higher incidence of low-lying placenta and placenta previa is sonographically diagnosed in the.
According to the best record based study of deaths following pregnancy and abortion, a government funded study in Finland, women who abort are approximately four times more likely to die in the following year than .