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. 2023 Sep;44(9):912-920.
doi: 10.15537/smj.2023.44.9.20230112.

Incidence, risk factors, and maternal outcomes of major degree placenta previa: A 10-year retrospective analysis

Mehad H AlQasem  1 , Ayman H Shaamash  1 , Deama S Al Ghamdi  1 , Ahmed A Mahfouz  1 , Mamdoh A Eskandar  1
Affiliations

Incidence, risk factors, and maternal outcomes of major degree placenta previa: A 10-year retrospective analysis

Mehad H AlQasem et al. Saudi Med J. 2023 Sep.

Abstract

Objectives: To determine the incidence, risk factors, and maternal outcomes of "major degree" placenta previa (PP)/placenta accreta spectrum (PAS) in Abha Maternity and Children's Hospital, Abha, Saudi Arabia. Secondly, to compare our findings to those of previous studies on PP/PAS in Saudi Arabia.

Methods: This is a retrospective study that included 299 patients diagnosed with major degree PP/PAS and admitted to Abha Maternity and Children's Hospital, Abha, Saudi Arabia, within 10 years (January 2012-December 2021). Also, we compared our results to the outcomes of PP/PAS patients in 6 previous Saudi studies.

Results: The total number of deliveries was 54,341; PP minor and major degrees were diagnosed in 376 (0.69%) patients. Of them, 299 patients had PP major degree (79.5%). The pattern of main risk factors for major PP/PAS included: elder age, high parity, and previous cesarean deliveries. Nearly 30.5% had evidence of PAS on antenatal MRI (n=91). Approximately 68.5% (n=205) of patients were delivered <37 weeks. Of 299 patients, 29 (9.7%)patients had emergency cesarean hysterectomy. The maternal mortality rate was 0.3% (n=1). Generally, in many aspects, our results are comparable to similar Saudi studies on PP/PAS.

Conclusion: Major degree of PP/PAS is associated with high maternal morbidity but rare mortality. Over 30 years, our patients' obstetric characteristics did not change, including both elder age and high parity. A substantial increase in the rate of cesarean deliveries is a leading cause of major PP/PAS.

Keywords: outcomes; placenta previa; risk factors.

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