Maternal Mortality Essay

MATERNAL OUTCOME

Maternal outcome in cases of PP depends upon type of PP, episodes of APH during pregnancy and their severity, pre- existing anaemia and availability of tertiary care facilities. Patients of PP are likely to have second and third trimester bleeding, more chances of operative deliveries, requirement of blood and blood products, PPH and different manoeuvres to tackle it, DIC, more chances of caesarean hysterectomy esp in placenta accreta, post operative infections, ARDS, pulmonary embolism and maternal mortality. Different studies have quoted different incidence rates of complications associated with PP.

Thorkild et al23Reports that increasing liberal use of caesarean section in modern obstetric practice adds to increasing maternal morbidity and also the incidence of placenta previa. He states that incidence of placenta previa is 5 times higher in patients with history of previous LSCSand patients with placenta previa had 6% risk of having caesarean hysterectomy.

- Patients with placenta previa had 6% risk of having caesarean hysterectomy.

- Incidence of placenta previa 5 times

A glance at these statistics from India

Tewari & Gulathi et al84 (1990) : no change in death due to hemorrhage i.e., 13.8% (1978-1983) & 14.8%(1984-1988)

Damania ,Walvekar et al85 1981) : In a review of maternal mortality over the last 20 years. Incidence of placenta previa decreased from 0.61 to 0.45.

Maternal mortality due to placenta previa decreased from 3.61 % to 0.97 %

Varawalla& Ingle et al86(1989) - In a study of maternal mortality from 1977 to 1986 , 35.6% deaths were due to hemorrhage out of which 10 % deaths were due to APH.

Jindhal et al87 (1989): 5 out of 158 deaths due to hemorrhage were due to APH.

Amit Sengupta et al 88,89 (1988): APH formed 4.65% of maternal