Maternal and fetal outcomes of placenta previa at a Rwandan referral hospital. Case of the University Teaching Hospital of Kigali

Abstract

Introduction: Placenta previa may be associated with significant adverse fetal and maternal outcomes including potential death. The aim of the study was to assess maternal and fetal outcomes associated with placenta previa at 1 Rwandan Referral Hospital: Kigali University Teaching Hospital, CHUK. Methods: This was a retrospective cross-sectional study of which data were collected for a period of 11 years from January 2010 to December 2020. We examined all medical files of patients admitted with placenta previa at the University Teaching Hospital of Kigali (CHUK). Results A total number of 250 women out of 23353 deliveries at CHUK during the study period had Placenta previa. The prevalence of placenta previa was 1.07%. Maternal mortality due to placenta previa was 1.2%. Placenta accrete spectrum was prevalent among 38 (15.2%) of all women with placenta previa . The Prevalence of PAS at first cesarean delivery (i.e.: no prior delivery) was 4.8%, and 10.7%, 34,1%, 29.4%, 25% at second, third, fourth, fifth and more cesarean delivery. The mean gestational age at delivery was 35.0±4.1 weeks. In the study, 16.0% of the neonates died while 84.0% survived, and 36.6% were admitted to NICU. Women undergoing cesarean delivery under general anesthesia were significantly associated with higher neonatal death (21.9% vs 11.7%, OR:2.110, p=0.030), higher rates of NICU admission (51.0% vs 26,1%, OR:2.949, p<0.001), lower Apgar score below 7 at first minute (49.5% vs 26.5%, 0R: 2.721, p=0.001).An Other factor significantly associated with neonatal death was birthweight . Conclusion The incidence of placenta previa among patients managed at the University teaching Hospital of Kigali is higher than worldwide incidence and other countries in the region. We recommend that the healthcare personnel provide adequate health education to patients with placenta previa about its complications