Placenta previa in a referral hospital in Oman

OBJECTIVE: To determine the incidence of placenta previa associated pregnancies, to find out the strength of association of identified risk factors with the major placenta previa associated pregnancies and to identify predictors for preterm outcome.

METHODS: Records of women with placenta previa, who delivered at Nizwa Hospital, Al-Dakhliya region, Sultanate of Oman between October 1998 and September 2002, were analyzed retrospectively utilizing a case control approach.

RESULTS: An incidence of 0.6% for placenta previa was noted in our study. Nearly two thirds (64.8%) of the pregnancies resulted in antepartum bleeding. Pregnancies with major placenta previa constituted 72% of all the subjects. Higher parity (>/=5), maternal age (>/=30) and history of previous abortion had high odds of association with major placenta previa of 2.1, 2.4 and 2.5. Antepartum hemorrhage was not significantly associated with pregnancies presenting with major placenta previa (odds ratio [OR] 1.3; p>0.05). The proportion of preterm deliveries was 55.5% in the study. There was a significant association between preterm outcome and presence of antepartum hemorrhage (OR 10.8; p<0.001).

CONCLUSION: In spite of higher maternal age, parity and previous abortions having high odds of presenting in pregnancies with major placenta previa, no significant statistical association could be proven. Also, no significant difference among pregnancies presenting with major or minor placenta previa as regards the preterm outcome, could be established. Antepartum hemorrhage, irrespective of severity, was a strong predictor of preterm outcome.