Abstract:

Background of the study: Placenta previa is the implantation of placental tissue partially or entirely within the lower segment of the uterus after 20 weeks of gestation, it may be partially or entirely covering the cervix. About one-third of cases of antepartum hemorrhage belong to placenta previa and occur after 28 weeks of gestational age. Clinically placenta previa presents with sudden onset of painless bleeding, that is recurrent without apparent reason or cause, usually occurs in the second or third trimester and if not earlier intervened can result in fatal complications including severe hypo-tension and shock due to antepartum hemorrhage, postpartum hemorrhage which can result on maternal death, on fetus can result on low birth weight, chance for congenital malformations, asphyxia, birth injuries and intrauterine death. The global prevalence is 5.2 per 1000, where Tanzania is estimated to be 0.6% though maternal and fetal deaths due to obstetric hemorrhage are still very high. Common risk factors include grand-multiparity, advanced maternal age above 35 years, history of previous cesarian section or any other scar in the uterus (myomectomy or hysterotomy), maternal history of smoking and prior curettage, and previous history of placenta previa.

Aim: The aim was to determine the prevalence of placenta previa, clinical presentations, and associated risk factors of placenta previa among pregnant women at Bugando Hospital.

Materials and methods: This was a retrospective cohort study of registered pregnant women at Bugando Hospital through well-constructed checklist questions aimed to explore the prevalence, clinical presentations, and associated risk factors of placenta previa, Data were analyzed by SPSS version 20 and both descriptive analysis and analytical analysis by using Chi-square tests, odds ratio, and predictive values were determined if statistically significant between associated risk factors and prevalence of placenta previa.

Study population: Pregnant women aged 15-44 years registered at Bugando Hospital between June 2020 to June 2022 were involved.

Results: 369 pregnant women were enrolled in the study for a period of 2 years, and 233(63.1%) were aged between 25-34 years. The prevalence was found to be 7.9% in which painless vaginal bleeding accounted for 92.6% as the main clinical presentation, and vaginal bleeding after 20 weeks accounts for 58%. On analysis of associated risk factors advanced maternal age was more likely associated with placenta previa (OR:7.56 95%CI 2.22 – 25.74) previous history of cesarian section by (OR:5.395%CI2.30 – 12.18), other factors include previous history of placenta previa, heavy drinking during pregnancy were statistically significant.

Conclusion: Placenta previa contributes to dreadful complications during pregnancy including antepartum and postpartum hemorrhage, low birth, and premature birth to fetus thus earlier diagnosis by ensuring early detection and initiate management will ensure to reduce these complications., obstetric ultrasound during 28 weeks and between 34 – 36 weeks will reduce emergency interventions.

Budget: All activities involved printing and binding of the research proposal, report work, the printing of checklist documents, stationaries, meals, and transport fees, and finally submission of the research report, which cost an estimated Tsh 250,000/=