Objectives: To study the demographics data and to compare the pregnancy outcome between primigravidas and multigravidas with placenta praevia in Hospital Tuanku Fauziah (HTF), Kangar, Perlis.
Method: A retrospective cohort study involving all placenta praevia patients delivered in Hospital Tuanku Fauziah, Kangar, from 1st January 2015 until 31st December 2016. The exclusion criteria are missing data. Data was retrieved from Delivery Book in Labour Room Hospital Tuanku Fauziah and from ILabHTF. All data were analysed using SPSS version 21.0. Permission was obtained from Ethical Committee HTF.
Results: During the 2-year period, 94 women had placenta praevia, accounting for 1.01% of total deliveries. All was delivered via caesarean section. 25.5% (N=24) were primigravidas, and 74.5% (N=70) were multigravidas. 39.4% (N=37) had minor praevia, and 60.6% (N=57) had major praevia. 19.1% (N=18) of the multigravidas had previous caesarean section scars. Mean gestational age at delivery was 36 weeks. Two thirds were delivered via emergency caesarean section. Massive postpartum haemorrhage occurred in 11.7% of cases (N=11) and adherent placenta in 6.4% (N=6), all of which involving multigravidas. 7.5% (N=7), 4.3% (N=4) and 1.1% (N=1) of patients required hysterectomy, bilateral internal iliac artery ligation and Bakri balloon insertion, respectively, all involving only multigravidas, as well. No case of maternal death occurred secondary to placenta praevia. There were 2 cases of macerated stillbirths but the respective patients did not have antepartum haemorrhage. Mean baby birth weight is 2.49±0.49 kg for primigravidas and 2.57±0.77 kg for multigravidas. Perinatal outcome is better for primigravidas, with mean cord pH 7.32±0.059, as compared to 7.07±1.22 for multigravidas. 23.4% of babies of multigravida women required NICU admission, as compared to 7.4% (N=7) for babies of primigravidas.
Conclusion: The incidence of placenta praevia in Hospital Tuanku Fauziah is akin to other studies. Multigravidas with placenta praevia carry higher pregnancy risks compared with primigravidas, thus highlighting the need for comprehensive obstetric care in managing these women.