FETOMATERNAL OUTCOMES IN PATIENTS WITH PLACENTA PREVIA AND PREVIOUS CESAREAN SECTION
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Abstract
Background: Placenta previa is a critical obstetric condition often associated with previous cesarean deliveries and presents a heightened risk of severe maternal and fetal complications. Its rising prevalence is closely linked to the global increase in cesarean section rates. The condition is known to cause significant hemorrhagic events and adverse perinatal outcomes. Early diagnosis, appropriate antenatal surveillance, and specialized obstetric care are crucial to minimize the associated risks and improve clinical outcomes.
Objective: To determine the prevalence and spectrum of feto-maternal outcomes in pregnancies complicated by placenta previa with a history of previous cesarean section.
Methods: This descriptive cross-sectional study was conducted at the Department of Obstetrics and Gynaecology, Khyber Teaching Hospital, Peshawar, from November 1, 2024, to April 30, 2025. A total of 270 pregnant women aged 16 to 40 years, with gestational age over 28 weeks and a history of cesarean section, were enrolled. Placenta previa was confirmed through ultrasound, and feto-maternal outcomes were evaluated. Outcomes assessed included antepartum hemorrhage, postpartum hemorrhage, renal impairment, maternal mortality, stillbirth, preterm delivery, and NICU admission. Data were analyzed using SPSS version 25.
Results: The mean age of participants was 30.44 ± 5.39 years, mean gestational age was 34.42 ± 4.88 weeks, and mean BMI was 23.90 ± 2.55 kg/m². Maternal mortality was observed in 61 patients (22.6%), antepartum hemorrhage in 49 (18.1%), postpartum hemorrhage in 45 (16.7%), and renal impairment in 45 (16.7%). Fetal outcomes included 50 stillbirths (18.5%), 35 preterm births (13.0%), and 17 NICU admissions (6.3%).
Conclusion: Placenta previa in women with a history of cesarean section poses substantial risks to both maternal and fetal health. Increased maternal mortality, hemorrhagic complications, and fetal losses emphasize the need for vigilant antenatal care and delivery planning in well-equipped centers.
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