P.PO.57 Management of placenta praevia

Published Date: 17th May 2017

Publication Authors: McCallin K, D'Costa D, , Harrison S

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Introduction 

Placenta praevia is associated with significant fetal and maternal morbidity and mortality. Careful management and compliance with evidence-based local guidelines is imperative to optimise both fetal and maternal outcomes.

Methods 

Women diagnosed with placenta praevia were retrospectively recruited from two neighbouring hospitals in North West England from a 6-month period. Cases were identified from Medway computer system and case-notes were retrieved. Data was collated and analysed versus pre-identified standards.

Results 

Twenty-nine cases met criteria for analysis. 7 (24.1%) women had major placenta praevia; 17 (58.6%) minor praevia. 7 (24.1%) delivered preterm (<37 weeks). Obstetric consultants were available during 100% deliveries. All those with anaemia were treated, and all had steroids after 24 weeks completed gestation. 13 (44.8%) women were symptomatic, 77% presented with spotting or mild ante-partum haemorrhage (APH). 16 (55.2%) delivered by elective caesarean section, 10 (34.4%) by emergency caesarean section and 3 (10.3%) had normal vaginal delivery. 5 (17.2%) had postpartum haemorrhage (PPH) with estimated blood loss >500 ml. There were no cases of maternal or fetal mortality, however all preterm babies were admitted to the Neonatal Unit.

Conclusion 

The number of cases in this study is too small to draw meaningful conclusion. Results confirm placenta praevia is a major cause of preterm birth and fetal morbidity. Placenta praevia is a significant cause of obstetric intervention. More research is required to determine overall significance when assessing excellence of obstetric units by CQC.

McCallin, K; D'costa, D; Nwosu, C; Shaman, S; Harrison, S. (2017). P.PO.57 Management of placenta praevia . BJOG: An International Journal of Obstetrics and Gynaecology. 124 (S2), 140

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