MAGNITUDE AND ASSOCIATED FACTORS OF PLACENTA PREVIA AMONG WOMEN WITH ANTEPARTUM HEMORRHAGE WHO WERE ADMITTED IN HIWOT FANA COMPREHENSIVE SPECIALIZED UNIVERSITY HOSPITAL, EASTERN ETHIOPIA

Abstract

Background:. Placenta previa, placenta overlying the os (to any degree) is one of the major causes of antepartum hemorrhage, contributing to significant maternal and perinatal morbidity and mortality. Although data on its contribution to bleeding is addressed, factors associated it and information on related maternal and perinatal outcomes is limited in Ethiopia in general and in Hiwot Fana Specialized University Hospital in particular. Objective: To assess magnitude and associated factors of placenta previa among women with Ante Partum hemorrhage who were admitted in Hiwot Fana Comprehensive Specialized University Hospital from June 1, 2019 to May 31, 2022. Methods: A hospital-based cross-sectional study was conducted on 409 women with Ante Partum Hemorrhage who were admitted from June 1, 2019 to May 31, 2022. Data on socio demographic characteristics, obstetric conditions and maternal and perinatal outcomes were collected using structured checklist from medical charts . Collected data entered in to Epidata 3.1 and analyzed using SPSS 21. Descriptive statistics (frequency, percentage , mean and median) was used to describe and present the results accordingly. Binary and multiple logistic regression analyses was fitted to identify factors associated with placenta previa. Adjusted Odds Ratio (AOR) along with 95% Confidence Interval (CI) was used to measure presence of association at p ≤ 0.05 Results : Of a total of 409 women with antepartum hemorrhage during the study. The magnitude of placenta previa was 26.4% [95%CI: 22.0% - 30.6%)]. Among the women with placenta previa 63.0% and 50% had adverse maternal and perinatal outcomes respectively. No antenatal care [AOR=1.76; 95% CI (1.08, 2.87)] and gestational age ≤33 weeks [AOR=2.75; 95% CI (1.37, 5.52)] and 34-36 weeks [AOR=1.91; 95% CI (1.16, 3.15)] were significantly associated with developing placenta previa among women with antepartum hemorrhage. Conclusions: A quarter of antepartum hemorrhage are from placenta previa. After adjusting for multiple confounders, not having antenatal care and preterm were found to increase the risks of placenta previa. Improving antenatal coverage and improving care for preterm births are essential for preventing adverse maternal and perinatal outcomes of placenta previa