Risk Factors and Clinical Outcomes of Abnormal Placental Localization: A comprehensive retrospective analysis

To evaluate maternal and neonatal complications associated with various types of placental abnormal localization.

This retrospective study analysed obstetric and neonatal outcomes associated with placental abnormal localization at Bahrain Defence Force Hospital over a 12-month period (January-December 2022). Women were categorized into four groups based on placental localization: placenta previa with accreta, placenta previa with increta, minor previa, and major previa. Maternal demographics, obstetric history, and fetal outcomes were collected. Statistical analysis included Fisher's exact test for categorical variables, the Kruskal-Wallis test for non-parametric variables, and one-way ANOVA for parametric variables. A p-value of <0.05 was considered statistically significant.

A total of 186 pregnant women aged 18-48 years with a diagnosis of placenta previa were included. Prior cesarean delivery and increased gravidity were identified as significant risk factors for abnormal placental implantation (p < 0.05). The highest incidence of hysterectomy (66%) occurred in the accrete, previa group. Maternal complications included anaemia, severe haemorrhage, and bladder injury, all of which were statistically significant. Prematurity was the most notable neonatal complication. Most patients had a hospital stay ranging from 3 to 8 days.

Placenta previa and placenta accreta spectrum (PAS) disorders represent serious obstetric challenges with significant maternal and neonatal morbidity. This study highlights key risk factors and complications, underscoring the importance of early identification and multidisciplinary management strategies to improve outcomes.