A Study to Evaluate the Effect of Antepartum Hemorrhage on Fetomaternal Outcomes in Major Degree Placenta Previa

Abstract

Background: Placenta previa is a major cause of antepartum hemorrhage (APH), associated with adverse maternal and neonatal outcomes. This study aimed to assess maternal characteristics, complications, mode of delivery, and neonatal outcomes among women with placenta previa presenting with and without APH.
Objective: This study aims to evaluate the effect of antepartum hemorrhage (APH) on fetomaternal outcomes among women with a major degree of placenta previa.
Methods: This cross-sectional observational study was conducted on 121 women diagnosed with placenta previa at the time of delivery. Participants were classified into placenta previa with APH (n=50) and placenta previa without APH (n=71) groups. Maternal demographics, obstetric history, placenta previa type, maternal complications, delivery mode, and neonatal outcomes were recorded at delivery. Statistical significance was set at p < 0.05.
Results: Maternal age, gravidity, parity, and previous cesarean sections did not differ significantly. The APH group had a higher mean number of previous abortions (1.56 ± 0.88 vs. 1.41 ± 0.59, p = 0.029). Type IV placenta previa was most common in both groups without significant difference. Anemia (54% vs. 15.5%), PROM (8% vs. 1.4%), and GDM (18% vs. 14.1%) were higher in APH group (p = 0.024). Emergency cesarean section was more frequent in APH group (56% vs. 25.4%, p=0.001). Maternal outcomes, including hysterectomy, transfusion, and ICU admission, were similar, but hospital stay was longer (5.86 ± 2.40 vs. 4.72 ± 1.70 days, p = 0.003). Neonates in the APH group had lower gestational age (36.04 ± 1.41 vs. 36.71 ± 1.49 weeks, p = 0.014), higher prematurity (58% vs. 28.4%, p < 0.001), lower birth weight (2.46 ± 0.48 vs. 2.76 ± 0.44 kg, p = 0.001), and increased malpresentation (22% vs. 4.2%, p = 0.011); Apgar scores were comparable.
Conclusion: APH in placenta previa is associated with increased maternal complications, emergency cesarean delivery, prolonged hospitalization, and adverse neonatal outcomes, including prematurity, low birth weight, and malpresentation. Previous abortion history may be an additional risk factor. Careful monitoring at delivery is essential to optimize maternal and neonatal outcomes. 

The Journal of Ad-din Women's Medical College; Vol. 14(1), Jan 2026; p 3-9