Comparison of Maternal Complications of Emergency vs Elective Caesarean Section for Placenta Previa

Abstract

Background: Placenta previa, being an obstetric emergency, is managed via either emergency or elective cesarean section depending upon clinical presentation of women. Multiple maternal and neonatal complications are associated with cesarean section varying with type of cesarean section.

Objective:  The study was designed to evaluate maternal complications of emergency vs elective cesarean section for placenta previa.

Material and Methods: This cohort study was conducted in Gynecology and Obstetrics Department, Lady Reading Hospital Peshawar after obtaining ethical approval from the Institutional Review Board in January 2024 till required sample size achieved April 2024. About 95 women with singleton pregnancy undergoing cesarean section (emergency or elective Cesarean section for placenta previa, with any maternal age included. Women were divided into two groups, emergency cesarean section (group 1) and elective cesarean (group 2).Maternal complications including post-partum hemorrhage (PPH),need for blood transfusion, post-operative fever and wound infection were recorded.

Results: The study showed mean age of 29.1±6.2 and 29.6±6.4 years for Group 1 and Group 2 respectively.  Statistically significant differences were found between emergency cesarean and elective cesarean section groups with respect to postpartum hemorrhage (47.9% vs 17% (P = 0.01), need for blood transfusion 91.6% vs 17% (P = 0.000),and postoperative fever (47.9% vs 12.7% (P = 0.001), while non significant difference observed for wound infection (4.1% vs 2.1% P=0.19).

Conclusion: Many maternal complications like postpartum hemorrhage, blood transfusion and postoperative fever were significantly higher in emergency cesarean compared to elective cesarean group for placenta previa.