Obstetric and Perinatal Outcomes in Pregnancies Complicated by Placenta Previa and Placental Abruption

Abstract

Antepartum hemorrhage is a grave and potentially life-threatening condition and a major cause of both maternal and fetal mortality. The study aims to compare the fetal and maternal outcomes of patients with placental abruption and placental praevia. This was a comparative retrospective case series study conducted in the University Hospital, Tripoli/Libya, during the year 2025. Seventy patients (35 with placenta previa and 35 with placental abruption) who were diagnosed by ultrasound were randomly selected for the study. The following data were obtained from the files: the age, gravidity, parity, history of previous abortion, history of bleeding, maternal outcome, mode of delivery, and fetal outcome. The mean age of the previa group was 28.4 years, and the mean of the abruption group was 26.7 years. Regarding the past obstetric history, the present study showed no significant differences between the two groups in terms of gravidity, parity, and previous abortion. Regarding the bleeding in previous pregnancies, about 5.7% of both groups had APH. PPH were as following 5.7% of the previa group and 11.4% of the abruption group. Only 1 case of the previa group had intrapartum bleeding. about 5.7% of the previa group had hypertension, and about 42.8% of the abruption group had hypertension. Only the abruption group had diabetes, with a percentage of 22.9%. PROM was higher in the abruption group (25.7%) than in the previa group (5.7%), while anemia was higher in the previa group (48.6%) than in the abruption group (28.6%). Regarding fetal outcome, the result showed the following: 2 cases (5.7%) of the previa group died compared to 13 cases (37.1%) of the abruption group. About 54.3% of the previa group neonates needed resuscitation, and about 85.7% of the abruption group needed resuscitation. Nursery admission was almost the same between the two groups (42.9% in the previa group and 40% in the abruption group). About 20% of both groups had respiratory problems. Prematurity was seen in 42.9% of the previa group versus 54.3% of the abruption group. Despite similarities, some patient characteristics and outcomes in APH due to placenta praevia compared to abruptio placenta differ. Abruptio placentae was associated with younger age, hypertension, diabetes, PROM, prematurity, fetal death, and neonatal resuscitation. Placenta previa was associated with older age, anemia, and nursery admission.