The increasing incidence of caesarean sections and maternal age globally predisposed more to the prevalence of placenta previa in the obstetric populace (Ikechebelu & Onwusulu, 2007). Uncomplicated cases of placenta previa must be delivered by elective cesarean section between 36 and 37 weeks. Stated risk factors for placenta previa in Myles Textbook For Midwives (2014) include the history of the previous cesarean section, termination of pregnancy, advanced maternal age, high parity, previous intrauterine surgery, smoking, and more than one pregnancies. Additionally, the placenta previa is a risk of delivering a small-for-gestational-age.
Ultrasonography is the diagnostic modality of preference for prognosis of placenta previa. Excessive hemorrhage can arise throughout operation while separating the placenta. In those cases, hysterectomy is considered the treatment of choice despite the fact that conservative management has lately been proposed. In spite of vast development in obstetric management and current transfusion service, antepartum hemorrhage remains one of the main reasons of maternal morbidity and mortality. An correct prognosis and activate resuscitation are the primary steps within the control of antepartum hemorrhage. Cases of placenta previa and placenta accreta are growing in numbers with the rising rate of cesarean section. It is found that higher morbidity related with exceptional sorts of placenta previa, along with whole or partial placenta previa and it is more than marginal placenta previa or low-lying placenta.
Each organization ought to have a clear plan and structure a protocol for the management of cases of massive hemorrhage. This particular protocol need to be often up to date, and steps and procedures need to rehearsed. The primary reasons of severe obstetrical hemorrhage are placenta previa, placental abruption, and postpartum hemorrhage. Those can cause extreme maternal morbidity and mortality if there is a delay in the diagnosis of hypovolemia and coagulation defects.
Marinating effective circulation by using a couple of intravenous line to correctly and directly pump blood products, fresh frozen plasma replacement-using crystalloids, further to invasive observing of the pulse rate and the blood pressure. Other available treatment modalities consist of using oxytocin and prostaglandins to maintain the uterus contracted, and surgical procedures to prevent bleeding by performing ligation of the uterine, ovarian or internal iliac arteries, or embolization by radiological assistance, or in the end hysterectomy while indicated.
` In general further education and expo-sure on placenta previa with its feasible complications must be emphasised to obstetric patients, to makesure proper attitude towards the medical advice given and be compliant to medicine in order to achieve maximum care for women with placenta previa. Consequently, efforts to improve the knowledge concerning placenta previa through quality improvement programs are very important in order to prevent avoid-able complications such as fetal mortality and maternal death secondary to uncon-trolled bleeding.