A comparative study of obstetrics outcome of placenta previa in scarred versus unscarred uterus at tertiary Hospital, Kathmandu, Nepal

Background: Placenta previa is an obstetric life-threatening condition with several maternal and fetal complications. The objective of this study is to compare the maternal and fetal outcome of placenta previa in scarred and unscarred uterus.Methods: A retrospective case control study was carried out on 85 cases of placenta previa in the department of obstetrics and gynecology, Paropakar Maternity and Womens Hospital (PMWH) Kathmandu from April 2019 to May 2020 of which 46 had scarred uterus and 39 cases had unscarred uterus.Results: Sixty-one of patients were less than 30 years of age, 62% presented with gestational age 28 to 37 weeks and 67% had parity between 1 to 5. Frequency of placenta previa in scarred uterus was 54% and that in unscarred uterus was 46%. Eighty percent cases with scarred uterus had anterior placenta compared to 33% of cases of unscarred uterus with p value of 0.009. 42% had grade 4 placenta previa on ultrasonography. 45 percent of patient with scarred uterus had PPH compared to 23% in unscarred group with p value of 0.03. Malpresentation was found in 7 cases in scarred group and in one case in unscarred. Cesarean hysterectomy was performed in 6 cases in scarred category compared to 2 in unscarred. Low birth weight was present in 28 cases in scarred category compared to 15 cases in unscarred category with p value 0.03.Conclusions: This study concluded that fetal and maternal outcome is adverse for cases of placenta previa with scarred uterus compared to unscarred uterus.