Incidence of hysterectomy in pregnant women with diagnosis of placenta previa

Abstract

Objective: To determine Incidence of hysterectomy in pregnant women with diagnosis of placenta previa.

Subjects and methods: 

A prospective observational study, Department of obstetrics and gynecology of Nishtar Hospital Multan from August 2022 to July 2023. We included 171 pregnant women who were diagnosed as case of placenta previa.  Age, gestational age, parity, height, weight were documented for all the patients. Placenta previa and its grade was confirmed by obstetrical ultrasound. Pfannenstiel incision was made for cesarean section. Decision for hysterectomy was made by the consultant gynecologist with a minimum of 5 years post fellowship experience. Effect modifiers such as age, parity, gestational age, history of cesarean section and, grades of placenta previa were controlled through stratification and post stratification chi-square test was applied and p ≤0.05 was considered statistically significant.

Results:  Mean age and weight of all the patients was 31.2 ± 4.1 years and 71.1 ± 13.1 kg, respectively. BMI of the patients was 29.9 ± 5.5 Kg/m². Mean gestational age and parity was 38.2 ± 1.5 weeks and 1.6 ± 1.3, respectively. Cesarean section was performed in 59.1% of the patients. Grade III and IV placenta previa was observed in 31% and 18.1% of the patients, respectively. Hysterectomy needed to be done in 29.2% of the patients.

Conclusion: The results of the study show that factors including parity, placental invasion abnormality and past history of cesarean sections determine the incidence of hysterectomy in the pregnant women diagnosed of placenta previa.