Publication:

A prospective observational study on maternal and perinatal outcomes in patients with placenta previa at a tertiary care centre

Background Placenta previa is a leading cause of antepartum hemorrhage associated with significant maternal and perinatal morbidity. Rising rates of cesarean sections have contributed to increasing prevalence. This study evaluates maternal and perinatal outcomes in placenta previa patients managed at a tertiary care centre. This study aimed to assess maternal complications (hemorrhage, anemia, blood transfusion, surgical interventions) and perinatal outcomes (preterm birth, low birth weight, NICU admission, neonatal mortality) in patients with placenta previa.

Methods A prospective observational study of 90 pregnant women diagnosed with placenta previa at GGMC and Sir JJ Hospital, Mumbai over a 14-month period (January 2022 to February 2023). Data on demographics, risk factors, comorbidities, maternal interventions, and neonatal outcomes were systematically collected and analyzed using descriptive statistics and chi-square tests.

Results The mean maternal age was 30.44±6.25 years. Previous uterine surgery was the predominant risk factor, present in 88.9% of patients. Antenatal hemorrhage occurred in 37.8% of cases. Maternal morbidity was substantial: 75.6% required blood transfusion, 48.9% required ICU admission, and 11.1% underwent obstetric hysterectomy. Placenta accreta spectrum (PAS) was identified in 13.3% of patients. Perinatal outcomes were significantly compromised: 53.3% of neonates were delivered early preterm (<34 weeks), 63.3% had low birth weight (<2.5 kg), 32.2% required NICU admission, and neonatal mortality was 11.1%. A statistically significant association was found between antenatal registration status and gestational age at delivery (χ²=19.437, p<0.001), with unregistered patients demonstrating markedly higher rates of early preterm delivery.

Conclusions Placenta previa remains a high-risk obstetric condition with considerable maternal and perinatal morbidity. Previous cesarean delivery is the most important risk factor. Early antenatal registration significantly improves gestational age at delivery and is associated with better perinatal outcomes. Multidisciplinary management in well-equipped tertiary centres, including blood bank preparedness, skilled surgical interventions, and NICU support, is essential for improving outcomes.