Frequency of Fetal Outcomes in Patients with Preexisting Placental Abnormalities. A Prospective Study in Tertiary Care Hospital
DOI:
https://doi.org/10.37762/jgmds.12-3.686Keywords:
Placenta Previa, Placenta Abruption, Placenta Accrete Spectrum (PAS)., Fetal congenital anomalies, Blood Transfusion, APGAR scoreAbstract
OBJECTIVES
This study aimed to access the various types of placental abnormalities and their impact on fetal well-being, including fetal admission to the nursery, complications, and outcomes.
METHODOLOGY
This cross-sectional study was conducted from September 1, 2022, to December 31, 2024, in the Obstetrics and Gynecology department of Ayub Medical Teaching Institute, Abbottabad, Pakistan. The sample size (n = 63) was calculated using the WHO calculator 1.1, with an estimated prevalence of placenta previa of 12%, an absolute precision of 8%, and a 95% confidence interval. Patients diagnosed with placental abnormalities on grey-scale sonography were followed until delivery and discharge. The non-probability convenient sampling technique was applied for the data collection. In the study, only 63 met the inclusion criteria. The different maternal and fetal parameters of morbidity and mortality were recorded on a predesigned written questionnaire. The data were analyzed using SPSS version 21. The statistical test, ANOVA and chi-square were used to determine the significance, and the significance value was kept below 0.05
RESULTS
Fifty-four per cent of individuals belonged to the 20-34 years age group, and this age group had the highest incidence of placental abnormalities, i.e., 54% (p = 0.002). The most common abnormalities were placenta previa (20/63). The mean weight of the baby was 2.3Kg±0.6. About 15% of newborns had congenital anomalies. Nearly half of the sample population's newborns needed admission to the NICU. The most common reason for admission to NICU was acute respiratory distress syndrome 14/28 (26%). About 6% of newborns suffer from hypoxemic ischemic encephalopathy (HIE). The newborn mortality was 19/63 (30%) and was high in previa and abruption with a significance of 0.00.
CONCLUSION
Although some congenital disabilities are difficult to detect in neonatal life but still careful observation of our cohort indicates that placental abnormalities increase the risk of congenital disabilities, adverse outcomes and mortality in newborns.
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Ward ZJ, Atun R, King G, Dmello BS, Goldie SJ. Global maternal mortality projections by urban/rural location and education level: a simulation-based analysis. Eclinicalmedicine. 2024 Jun1;72. https://doi.org/10.1016/j.eclinm.2024.102653. DOI: https://doi.org/10.1016/j.eclinm.2024.102653
Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. The lancet. 2006 Apr 1;367(9516):1066-74 https://doi.org/10.1016/S0140-6736(06)68397-9. DOI: https://doi.org/10.1016/S0140-6736(06)68397-9
McClure EM, Saleem S, Goudar SS, Tikmani SS, Dhaded SM, Hwang K, Guruprasad G, Shobha D, Sarvamangala B, Yogeshkumar S, Somannavar MS. The causes of stillbirths in south Asia: results from a prospective study in India and Pakistan (PURPOSe). The Lancet Global Health. 2022 Jul 1;10(7):e970-7. https://doi.org/10.1016/S2214-109X(22)00180-2 DOI: https://doi.org/10.1016/S2214-109X(22)00180-2
Bangash AG, Afridi F, Akhtar N, Riaz S. The Etiology of Stillbirths Using Relevant Condition at Death (ReCoDe) Classification System; Experience in a tertiary care Hospital. Journal of The Society of Obstetricians and Gynaecologists of Pakistan. 2024 May 28;14(2):123-7. https://www.jsogp.net/index.php/jsogp/article/view/745
Afshan, K., Narjis, G., & Qayyum, M. (2019). Risk factors and causes of stillbirths among pregnant women in Pakistan. African Health Sciences, 19(1), 1507. https://doi.org/10.4314/ahs.v19i1.24 DOI: https://doi.org/10.4314/ahs.v19i1.24
M. Damodaram, L. Story, E. Eixarch, A. Patel, A. Mcguinness, J. Allsop, J. Wyatt- Ashmead, S. Kumar, M. Rutherford, Placental MRI in intrauterine fetal growth restriction, Placenta 31 (2010) 491–498. https://doi.org/10.1016/j.placenta.2010.03.001 DOI: https://doi.org/10.1016/j.placenta.2010.03.001
S. Dahdouh, N. Andescavage, S. Yewale, A. Yarish, D. Lanham, D. Bulas, A.J. Du Plessis, C. Limperopoulos, In vivo placental MRI shape and textural features predict fetal growth restriction and postnatal outcome, J. Magn. Reson. Imag. 47 (2018) 449-458. https://doi.org/10.1002/jmri.25806 DOI: https://doi.org/10.1002/jmri.25806
Sun C, Groom KM, Oyston C, Chamley LW, Clark AR, James JL. The placenta in fetal growth restriction: what is going wrong?. Placenta. 2020 July 1;96:10-8. https://doi.org/10.1016/j.placenta.2020.05.003 DOI: https://doi.org/10.1016/j.placenta.2020.05.003
Khan M, Khan N, Noor S, Hussain A, Rahman HU, Irshad S, Khan F. Frequency of Maternal Morbidities in Patients with Placenta Previa-A Prospective Single-Centered Study in Hazara Division. Journal of Gandhara Medical and Dental Science. 2024 Sep 30;11(4):3-6. https://doi.org/10.37762/jgmds.11-4.616 DOI: https://doi.org/10.37762/jgmds.11-4.616
Jauniaux E, Dimitrova I, Kenyon N, Mhallem M, Kametas NA, Zosmer N, Hubinont C, Nicolaides KH, Collins SL. Impact of placenta previa with placenta accreta spectrum disorder on fetal growth. Ultrasound in Obstetrics & Gynecology. 2019 Nov;54(5):643-9. https://doi.org/10.1002/uog.20244 DOI: https://doi.org/10.1002/uog.20244
Moeini R, Dalili H, Kavyani Z, Shariat M, Charousaei H, Akhondzadeh A, Naddaf A, Nayyeri FS. Maternal and neonatal outcomes of abnormal placentation: a case-control study. The Journal of Maternal-Fetal & Neonatal Medicine. 2021 Oct 2;34(19):3097-103. https://doi.org/10.1080/14767058.2019.1678128 DOI: https://doi.org/10.1080/14767058.2019.1678128
Kong F, Fu Y, Shi H, Li R, Zhao Y, Wang Y, Qiao J. Placental abnormalities and placenta-related complications following in-vitro fertilization: based on national hospitalized data in China. Frontiers in Endocrinology. 2022 June 30;13:924070. https://doi.org/10.3389/fendo.2022.924070 DOI: https://doi.org/10.3389/fendo.2022.924070
Jenabi E, Bashirian S, Khoshravesh S. The association between of placenta previa and congenital abnormalities: a systematic review and network meta-analysis. BMC pediatrics. 2023 Nov 30;23(1):606. https://doi.org/10.1186/s12887-023-04433-z DOI: https://doi.org/10.1186/s12887-023-04433-z
Viana Pinto P, Kawka‐Paciorkowska K, Morlando M, Huras H, Kołak M, Bertholdt C, Jaworowski A, Braun T, Fox KA, Morel O, Paping A. Prevalence of fetal anomalies, stillbirth, neonatal morbidity, or mortality in pregnancies complicated by placenta accreta spectrum disorders. Acta obstetricia et gynecologica Scandinavica. 2024. https://doi.org/10.1111/aogs.14919 DOI: https://doi.org/10.1111/aogs.14919
Riihimäki O, Metsäranta M, Paavonen J, Luukkaala T, Gissler M, Andersson S, Nuutila M, Tikkanen M. Placental abruption and child mortality. Pediatrics. 2018 Aug 1;142(2).https://doi.org/10.1542/peds.2017-3915 DOI: https://doi.org/10.1542/peds.2017-3915
Siddiqui SA, Tariq G, Soomro N, Sheikh A, Shabih-ul-Hasnain F, Memon KA. Perinatal outcome and near-miss morbidity between placenta previa versus abruptio placentae. Journal of the College of Physicians and Surgeons Pakistan. 2011 Feb 1;21(2):79-83. https://jcpsp.pk/archive/2011/Feb2011/05.pdf
Varlas VN, Bors RG, Birsanu S, Maxim B, Clotea E, Mihailov M. Maternal and fetal outcome in placenta accreta spectrum (PAS) associated with placenta previa: a retrospective analysis from a tertiary center. Journal of Medicine and Life. 2021 May;14(3):367. https://doi.org/10.25122/jml-2021-0134 DOI: https://doi.org/10.25122/jml-2021-0134
Cahill AG, Beigi R, Heine RP, Silver RM, Wax JR, American College of Obstetricians and Gynecologists. Placenta accreta spectrum. American journal of obstetrics and gynecology. 2018 Dec 1;219(6):B2-16. https://doi.org/10.1016/j.ajog.2018.09.042 DOI: https://doi.org/10.1016/j.ajog.2018.09.042
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Copyright (c) 2025 Niama Khan, Mohsin Khan, Faiza khan, Muhammad Kashif Rafiq, Kiran Khushal, Ahtezaz Hussain , Fatima Akhtar Khan
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