OBSTETRIC RISK FACTORS ASSOCIATED WITH MAJOR DEGREE PLACENTA PRAEVIA DEVELOPMENT

Objective: to evaluate potential risk factors and perinatal outcome of pregnancies completed with major degree placenta praevia in pregnant women studied in gynae-a unit of postgraduate medical institute, lady reading. hospital, peshawar material and methods: this retrospective case-control study included a total of 114 pregnancies with major placenta praevia during one year study period, from jan-dec.2005, and 671 randomly selected simple singleton control. studied in gynae-a unit of postgraduate medical institute, lady reading hospital, peshawar. data on potential risk factors for placenta praevia development were extracted from medical records. data was statistically analyzed with chi-square test and mann whitney u test, and crude odds ratio (or) with 95% confidence interval (ci) were provided. results: the incidence of major degree placenta praevia was 1.9%. factors significantly associated with a major placenta praevia development were advanced maternal age(or 2.66;ci 1.76-4.0) (especially >34 years, even after adjustment for high parity), multiparty (or 2.2; ci 1.42-3.40), history of previous cesarean sections (or 2.0; ci 1.02-4.06), previous abortions (or 2.8; ci 1.85-4.23), and presence of various uterine abnormalities (or 9.0; ci 2.42-54.5).the risk was significantly increased after two previous cesarean sections and even after one previous abortion. the main perinatal complication was preterm birth, with almost 11-fold higher risk in women with placenta praevia. conclusion: the most important obstetric factors for placenta praevia development were; advanced maternal age especially >34 years, 3 or more previous pregnancies (gravidity), parity of > 2, rising number of previous abortions, and history of previous cesarean sections. preterm delivery still remains the greatest problem in pregnancies complicated with placenta praevia