Comparison of Maternal and Fetal Outcome in Placenta Previa between Elective versus Emergency Cesarean Section in Libya

Abstract

Background and aims. Placenta previa is a serious obstetric complication that affects 0.3% and 0.5% of all live births. It is linked to an elevated risk of preterm birth as well as perinatal mortality and morbidity. Cesarean section is advised for women with placenta previa. There is limited data about feto maternal complication of placenta previa in comparison between elective versus emergency cesarean section in Libya. The aim of this study was to compare the maternal and fetal outcome of elective and emergency caesarean section in placenta previa cases. Methods. A retrospective study was done in Aljala Maternity Hospital in Tripoli, Libya. Hospital records for the entire cohort of women who underwent cesarean section due to placenta previa over one year (January to December, 2018) were collected. The following data was obtained, age, gravidity, parity and history of abortion, history of cesarean section, maternal and neonatal outcome, and site and grade of placenta. Results. The prevalence of placenta previa was 5.2 per 1 000 births. About 56.3% of placenta previa cases was accidentally discovered in outpatient department, 41.8% of the cases asymptomatic and 43.6% had vaginal bleeding, 57.27% underwent planned cesarean delivery, and 32.7% required emergency cesarean delivery. The maternal complication such as intraoperative bleeding was 35.1% in the elective and 77.8% in the emergency. All babies who delivered by emergency were alive but in elective were 5.4% intrauterine fetal death. Conclusion. Placenta previa remains a risk factor for cesarean section delivery which adversely leads to various feto maternal complications in Libya.