Placenta Praevia in a Tertiary Hospital: Prevalence, Risk Factors and Fetomaternal Outcomes

Abstract

Background: Placenta praevia is a significant obstetric complication and remains an important cause of antepartum haemorrhage, contributing substantially to maternal and perinatal morbidity and mortality worldwide. The burden is particularly high in low- and middle-income countries, where delays in diagnosis, limited access to blood products, and suboptimal referral systems often worsen outcomes. Preventive strategies, early diagnosis through antenatal ultrasonography, and appropriate obstetric intervention are crucial in reducing adverse fetomaternal consequences. Objective: This study aimed to determine the prevalence of placenta praevia, describe the sociodemographic characteristics of affected women, identify associated risk factors, and evaluate fetomaternal outcomes among women managed for placenta praevia in a tertiary health facility. Study Design: A retrospective descriptive study of women managed for placenta praevia conducted at the Federal Medical Centre, Yenagoa, Bayelsa State, between 1st January 2018 and 31st December 2020. Results: During the three-year study period, a total of 2,375 deliveries were recorded, of which 38 were complicated by placenta praevia, resulting in a prevalence of 1.6%. The mean maternal age was 32.7 years. The highest proportion of cases (42.1%) occurred among women aged 31–35 years. Placenta praevia was more common among primiparous women (42.1%), followed closely by multiparous women (39.4%). There was no difference in booking status, with equal proportions of booked and unbooked patients. Most women were married (89.5%) and employed (73.7%). Previous caesarean section was the most frequently identified risk factor, present in 55.3% of cases. Other risk factors included previous dilatation and curettage, prior placenta praevia, previous myomectomy, and multiple pregnancy. Nearly all pregnancies resulted in live births, with only one stillbirth recorded. All women were delivered by caesarean section. Preterm delivery occurred in 52.5% of cases. Postpartum haemorrhage complicated 26.3% of deliveries, while 55.3% of women required blood transfusion. Forty percent of the neonates were admitted to the Special Care Baby Unit. No maternal deaths were recorded during the study period. Conclusion: Placenta praevia accounted for 1.6% of deliveries in the study centre and was most common among primiparous women with a history of caesarean section. Prompt diagnosis and timely caesarean delivery resulted in favourable maternal and neonatal outcomes, with no recorded maternal mortality.