TITLE:
Caesarian Section for Placenta Praevia: Does Booking Status Affect Maternofetal Outcome?
AUTHORS:
Oshodi Yusuf Abisowo, Akinola Oluwarotimi Ireti, Fabamwo Adetokunbo Olusegun, Olaifa Ibrahim Adeniyi, Oyedele Yekeen Oyedokun
KEYWORDS:
Placenta Praevia, Maternal Outcome, Fetal Outcome, Booking Status, Caesarian Delivery
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.6 No.5,
April
28,
2016
ABSTRACT: Background: Placenta praevia accounts for significant maternal morbidity
and perinatal morbidity and mortality. Despite advances in blood transfusion
technique and surgical procedure, abnormal placentation still remains a
difficult challenge for obstetricians. Objective: To determine the influence of
booking status on the fetal and maternal outcome among parturients with placenta
praevia that underwent caesarian delivery. Methodology: This was a comparative
and retrospective study between booked and unbooked subjects with significant
placenta praevia that were delivered by caesarian section between January 1st 2004 and December 31st 2008 with respect to maternal and fetal
outcome. Result: Out of 14,344 deliveries during study period, 123 cases of
placenta praevia that underwent caesarian delivery were identified giving a
prevalence rate of 0.86%. 49 subjects were booked while 74 were unbooked. There
was no statistically significant difference
between booked and unbooked cases with respect to risk factors (30.6% of booked
and 23% of unbooked), X2(4) = 7.203, P = 0.126 and the mean blood
loss at surgery (870.4 ± 486.9 ml in booked versus 779.7 ± 380.96 ml in
unbooked), X2(1) = 0.202, P = 0.653. However, antepartum transfusion
(12.2% booked versus 34.7% unbooked) and postpartum transfusion (51% booked
versus 72% unbooked) showed statistically significant difference, X2(1)
= 9.744, P = 0.002. One maternal death occurred amongst the unbooked cases and
none among the booked cases. Statistically significant differences were also
noted in the apgar score at 1 minute X2(3) = 15.528, P = 0.001 and 5
minutes X2(3) = 12.912, P = 0.005 respectively. More babies died in
the unbooked group (19) compared to two (2) in the booked mothers. Conclusion:
Unbooked status in placenta previa significantly increases the risk for
antepartum and postpartum transfusion, is associated with higher mortality,
increased preterm delivery, poorer apgar scores and higher perinatal mortality
rate.