Razia Mehboob, Nazir Ahmad.
Fetal outcome in major degree placenta praevia.
Pak J Med Res Jan ;42(1):3-6.

This study was conducted to evaluate the fetal outcome in pregnancies complicated with major degree placenta praevia. Majority of the painless vaginal bleeding in the second half of the pregnancy were associated with major degree placenta praevia, which was more common in neglected pregnancies and increased parity with advancing age. The risk was also increased in scarred uterus (previous caesarean section and D & C). Mal-presentations were associated with major degree placenta praevia. Maternal mortality was controlled by performing immediate caesarean section in patients having moderate to heavy vaginal bleeding, but increased perinatal mortality and morbidity were still the important problems. The introduction of Macafee’s expectant management had reduced the perinatal mortality rate, but for this purpose good antenatal care was required and reduction in emergency cases was necessary. The most important cause of perinatal mortality and morbidity was prematurely. The deliveries of the premature babies were avoided as the condition of the mothers allowed and the mother with preterm were given Inj. Dexamethasone to enhance their lung maturity. It was concluded that mothers who had expectant management and received prenatal Dexamethasone shots along with good neonatal unit facilities had improved immediate fetal outcome in term of better APGAR score, reduced prevalence of respiratory distress syndrome, anaemia and jaundice.

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