Management of placenta praevia: a comparison between 1991 and 2001 in the Rotunda Hospital

Abstract

Obstetric haemorrhage is still leading cause of maternal mortality. Placenta praevia remains a leading cause of obstetric haemorrhage. We therefore aimed to determine the incidence of placenta praevia in 1991 and 2001, to ascertain any differences in diagnosis and management and to investigate the outcome in terms of maternal morbidity. A retrospective chart review was performed. Patients were identified from the labour ward register and charts obtained. Relevant information was gathered from the charts by one investigator. In 1991, 19 (0.286) deliveries were associated with placenta praevia and in 2001 there were 27 (0.37%). The average age of women with placenta praevia was 35 years in 1991 and 33 years in 2001; seven (36%) had at least one previous caesarean section in 1991 and six (22%) had a previous caesarean section in 2001. Mode of presentation was on routine ultrasound in 12 cases (63%) in 1991 and 11 cases (40%) in 2001. Antepartum haemorrhage was the presenting complaint in five cases (26%) in 1991 and in 16 cases (60%) in 2001. Two women (10%) presented in labour in 1991 and one (3%) in 2001. In both 1991 and 2001, a total of two women were diagnosed at delivery. Delivery was performed by obstetric consultant staff in 31% of cases in 1991 and 55% in 2001. Anaesthetic service was supplied by consultant staff in 52% of cases in 1991 and in 70% in 2001. Spinal anaesthetic was used in eight women (42%) in 1991 and in 16 women (60%) in 2001.