Year: 2025 | Month: March | Volume: 12 | Issue: 3 | Pages: 7-14
DOI: https://doi.org/10.52403/ijrr.20250302
Placenta Praevia: A Five-Year Review of Prevalence, Trend and Risk Factors in A Tertiary Hospital, Enugu, Nigeria
Livinus Nnanyelugo Onah1, Malachy Nwaeze Ezenwaeze1, Kelvin Emeka Ortuanya1
1Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Enugu, Nigeria.
Corresponding Author: Malachy Nwaeze Ezenwaeze
ABSTRACT
Background: Placenta praevia accounts for a considerable proportion of maternal morbidity and mortality globally especially in low- and middle-income countries where access to timely obstetric care may be limited.
Objective: This study assessed the prevalence, trend and risk factors of placenta praevia at the Enugu State University Teaching Hospital (ESUT-TH), South-East Nigeria.
Methods: This was a descriptive cross-sectional study of all cases of placenta praevia managed at the Enugu State University Teaching Hospital (ESUT-TH) Parklane, from 1st January 2019 to 31st December 2023. All cases of placenta praevia were collated from the labour ward, post-natal and the theatre registers. A well-structured study proforma was designed and used to collect data on sociodemographic/obstetric factors, types of placenta praevia and risk factors. Both clinical and radiological assessments were employed in the diagnosis. The collected data was analysed using the Statistical Package for Social Sciences (SPSS) (IBM Chicago) version 28. Categorical variables were presented in frequencies and percentages while symmetrical continuous variables were presented using mean and standard deviations with 95% confidence intervals around the point estimates.
Results: Over the 5-year study period, 10,020 deliveries, and two hundred and one (201) cases of placenta praevia were observed, giving the prevalence of placenta praevia at 2% or 20.1 per 1000 deliveries. The mean (SD) age and gestational age were 32.6 (±4.7) years and 35.7 (±3.3) weeks respectively. Majority of the research participants 77(38.3%) were between 30-34 years of age. Most of the participants 78(39) also had secondary level of education followed by 72(36%) who had tertiary education. The least number 51(25%) had primary education. One hundred and ninety-two participants (96%) were Christians while nine participants (5%) were non-Christians. More than half, 57.7% were multiparous. The majority of the patients, 113(56%) booked for antenatal care. The rate of occurrence of placenta praevia showed an upward trend, it increased from 2.5 in 2019 to 5.4 in 2023. Out of the 201 recorded cases of placenta praevia, type 1 praevia occurred in 16.4% of participants, type 2 in 24.4%, type 3 in 39% while type 4 praevia occurred in 20.4%. The commonest risk factor observed from the study was previous caesarean section 87 (43.3%), followed by high parity 33(16.4%). Other observed risk factors in decreasing frequency include surgical evacuation of uterus (12.4%), Prior myomectomy (9.4%), advanced maternal age (5%), Previous placenta praevia (4.5%), multiple pregnancy (4.5%) and co-existing uterine fibroid (2.5%). There were no identifiable risks in 2%
CONCLUSION: The prevalence of placenta praevia in Enugu State University Teaching Hospital is 2%. There is a trend towards an exponential increase in the prevalence rate of praevia in ESUT-TH with previous caesarean delivery as the commonest risk factor.
Awareness of the above findings will help in instituting measures to reduce the risks of placenta praevia as well as its associated morbidity and mortality
Keywords: Placenta praevia, prevalence, trend, risk factors
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