Comparison of Pregnancy Outcome in Placenta Previa versus Placenta Abruption

Objective: To compare the maternal and fetal complications, due to placenta previa and placental abruption. Design: A comparative cross sectional study Place and duration of study: Gynae Unit I, Allama Iqbal Medical College/Jinnah Hospital, Lahore, from January 2008 to December 2008. Patients and methods: The patients were divided into two equal groups. Group A & group B each comprised of 60 consecutive patients who presented with placenta previa and placental abruption respectively and had duration of pregnancy 28 weeks or more. All the patients with placenta previa were diagnosed by ultrasound, where as placental abruption was diagnosed on the clinical features. The patients with duration of pregnancy less than 28 weeks, multiple pregnancy and past history of caesarean section were excluded from the study. Age, parity, gestational age, predisposing factors like hypertension, anaemia and polyhydraminos, symptoms of abruption, mode of delivery and fetal outcome were studied. Results: 46(76.7%) patients in group A and 20(33.3%) patients in group B were delivered abdominally. Hypertension was present in 14(23.3%) patients and 46(76.7%) patients in group A and group B respectively. Diabetes was noted in group B only. 2(6.6%) patients of group B presented with the history of trauma. Perinatal deaths were 4(13.4%) and 28(46.7%) in group A and B respectively. 24(40%) and 40(66.7%) patients of group A and group B had babies with low birth weight (<2.5kg). Conclusion: Antepartum haemorrhage is an obstetric emergency associated with significant maternal and fetal morbidity and mortality. Prematurity is the single most common cause of neonatal mortality.