Prevalence and Fetomaternal Outcome of Placenta Previa at Salmaniya Medical Complex, Bahrain

Background Placenta previa is a condition which occurs when the placenta implants in the lower uterine segment, thus obstructing delivery. It is considered a grave pregnancy complication as it is associated with massive maternal hemorrhage. The condition is associated with previous cesarean delivery, multiple gestations, and increased maternal age. The placental villi may abnormally adhere, invade, or penetrate the myometrium causing accreta, increta, or percreta, respectively. It is the most common indication of peripartum hysterectomy. The gold standard for diagnosis of placenta previa is transvaginal ultrasound.  Objective This study aims to calculate the prevalence of placenta previa in relation to the known risk factors and to determine the fetomaternal outcome which will aid in improving the obstetric care of patients with placenta previa.  Methods A total of 216 placenta previa cases diagnosed between October 2014 and December 2018 were evaluated in a retrospective cross-sectional study. Analysis of the data was conducted using SPSS software, version 20 (IBM Corp., Armonk, NY). Results The total number of deliveries during the study period was 25,693 out of which 216 were diagnosed with placenta previa. Thus, the prevalence of placenta previa is 0.84%. The mean age at diagnosis was 32.8 years. At diagnosis, 23.1% of the cases were primiparous. Of the 216 patients, 1.9% were diagnosed with placenta percreta, of which 5.1% received a hysterectomy; 59.7% had uncomplicated elective cesarean delivery at 37-38 weeks of gestation. The mean gestational age at emergency delivery was 35.97 (+-3.1). Conclusion The study highlights that although risk factors increase the likelihood of placenta previa, it is necessary to rule it out in women with no known risk factors.