Incidence, Risk Factors and Post-Operative Outcome of Cesarean Hysterectomy Among Placenta Previa Patients at a Tertiary Hospital

Introduction:
Placenta previa remains a significant obstetric complication associated
with maternal morbidity, particularly when coupled with abnormal
placentation and previous cesarean deliveries.
Objective:
This study aimed to assess the incidence, risk factors, and postoperative
outcomes of cesarean hysterectomy among placenta previa patients at a
tertiary hospital in Bangladesh.
Methods:
The cross-sectional observational study was conducted in the
Department of Obstetrics and Gynaecology at Dhaka Medical College
and Hospital, over a period of six months, from July 2017 to December
2017, including 50 pregnant women with confirmed placenta previa.
Results:
Cesarean hysterectomy was required in 20% of placenta previa cases,
predominantly among patients with central placenta previa and prior
cesarean deliveries. Multiparity, irregular or absent antenatal care, and
a history of uterine curettage were prominent risk factors. Postoperative
complications occurred in 50% of hysterectomy cases. Despite a high
live birth rate (90%), 30% of newborns had low birth weight, and 24%
required NICU admission.
Conclusion:
Cesarean hysterectomy remains a vital but high-risk intervention in
managing complicated placenta previa. Early identification of high-risk
patients, rational use of cesarean sections, and coordinated
multidisciplinary care are essential to reduce maternal and perinatal
complications