Placenta previa : An ultimate everlasting obstetric emergency

Objective: The current study is a cohort observational prospective study with the aim of assessment and auditing of the detrimental effects and consequences of placenta previa (PP), which is considered by most obstetricians an ultimate obstetric risky condition, top surgical emergency and stressful condition for both the patient as well as the obstetrician. Such condition despite being linked to previous surgeries resulting in uterine wall scarring, yet considerably many cases with no previous uterine surgeries are presenting with such condition.
Patients and Methods: Two groups of patients; group (A) including 89 patients diagnosed with PP at/or near full term and group (B) included 82 patients with high order (repeated) cesarean section (CS) were followed prior to, during and after delivery via CS with specific predetermined parameters such as hemoglobin level, postpartum hysterectomy, amount of blood transfusion and neonatal NICU admission. Those parameters used for assessment of the deleterious effects of both conditions on both the mother and newborn and both conditions were compared for the extremity of hazard.
Results:There was considerably significant drop in HB level and amount of blood transfusion between both groups with drop of HB level from 11.7gm/dl to 9gm/dl in group A ladies, whereas group B ladies had a drop from 11.8gm/dl to 10.1gm/dl. Also, 35 mothers needed blood transfusion in group A compared to 6 mothers in group B. Furthermore, 7 ladies had their uterus removed in group A as a salvage procedure compared to 1 lady in group B. Concerning NICU admission, 28 neonates for the mothers in group A were admitted to the NICU compared to 12 in group B.
Conclusion: PP was recognized to be an obstetrical condition with ultimate risk to both the mother and newborn in comparison to other well-known high risk obstetrical conditions such as high order (multiple repeated) cesarean delivery.