Migration of Placenta Previa in Patients Presenting in A Tertiary Care Hospital and Feto-maternal Outcome

Authors

Ayesha Saif Associate professor, Consultant Obstetrician and Gynecologist, Lahore Medical and Dental College/ Ghurki Trust Teaching Hospital, Lahore
Zunaira Hafeez PG Trainee, Department of Obstetrics and Gynaecology, Ghurki Trust Teaching Hospital, Lahore.
Sadia Ilyas Assistant Professor, Department of Obstetrics and Gynecology, Lahore Medical and Dental College/ Ghurki Trust Teaching Hospital, Lahore
Muhammad Ali Rauf Postgraduate resident, Department of Radiology, Lahore Medical and Dental College/ Ghurki Trust Teaching Hospital, Lahore
Shadia Shah Senior Registrar, Department of Obstetrics and Gynecology, Lahore Medical and Dental College/ Ghurki Trust Teaching Hospital, Lahore
Nabeela Shami Professor and Head, Department of Obstetrics and Gynecology, Lahore Medical and Dental College/ Ghurki Trust Teaching Hospital, Lahore

DOI:

https://doi.org/10.51273/esc25.251321119

Keywords:

Placenta Previa, Migration, Cesarean section, Feto-maternal outcomes

Abstract

Abstract
Objective: To investigate the migration of placenta previa and its feto-maternal outcomes in patients
presenting at a tertiary care hospital.
Material and Methods: The study was conducted at the Obstetrics and Gynaecology Department of Ghurki
Trust Teaching Hospital over a two-year period, from March 2021 till March 2023, following the approval
from the Institutional Review Board. This study included 50 patients who met the specified inclusion
criteria. Using a pre-designed proforma, data was collected on placental location (low-lying or previa,
anterior or posterior) at both 20 and 32 weeks of gestation to assess migration. Additionally, demographic and
clinical information, including maternal age, gravidity, parity, obstetric history, fetal gender, fetal
presentation, delivery mode, and neonatal outcomes were recorded. The data was analyzed using SPSS
software (version 22) and the results were presented as frequencies, percentages, and tables. The chi-square
test was used to evaluate associations (95% confidence interval) considering p-values < 0.05 statistically
significant.
Results: The migration of placenta previa was 38%. Posterior placenta previa was more common (62%) and
migrated more frequently (63%) than anterior placenta previa. Primigravida women placenta previa.
Placenta previa was associated with male fetuses (59%) and breech presentation (22%). Moreover, the study
revealed that 42% women needed blood transfusions during childbirth and 6% experienced anemia related
complications, underscoring maternal risks.
Conclusion: Understanding placenta previa migration and its associated factors helps to better plan the mode
and timing of delivery, improving maternal and fetal outcomes.
Keywords: Placenta previa, migration, Cesarean section, feto-maternal outcome
How to cite: Saif A, Hafeez Z, Ilyas S, Rauf MA, Shah S, Shami N. Migration of Placenta Previa in Patients Presenting
in A Tertiary Care Hospital and Feto-maternal Outcome. Esculapio - JSIMS 2025;21(01): 105-109
DOI: https://doi.org/10.51273/esc25.251321119

References

Kern-Goldberger AR, Haeri S, Lindsley W, Srinivas

SK. Examining ultrasound diagnostic performance

improvement with utilization of maternal-fetal

medicine tele-interpretation. American Journal of

Obstetrics Gynecology MFM. 2021;3(5):100389.

https://doi.org/10.1016/j.ajogmf.2021.100389.

Imafuku H, Tanimura K, Shi Y, Uchida A, Deguchi

M, Terai Y. Clinical factors associated with a placenta

accreta spectrum. Placenta. 2021;112:180-4.

https://doi.org/10.1016/j.placenta.2021.08.001.

Morlando M, Collins S. Placenta accreta spectrum

disorders: challenges, risks, and management

strategies. International Journal of Women's Health.

:1033-45. https://doi.org/10.2147/

ijwh.s224191.

Alouini S, Megier P, Fauconnier A, Huchon C, Fievet

A, Ramos A, et al. Diagnosis and management of

placenta previa and low placental implantation. The

Journal of Maternal-Fetal Neonatal Medicine.

;33(19):3221-6. https://doi.org/10.1080/

2019.1570118.

Jansen CH, Kleinrouweler CE, van Leeuwen L,

Ruiter L, Mol BW, Pajkrt E. Which second trimester

placenta previa remains a placenta previa in the third

trimester: a prospective cohort study. European

Journal of Obstetrics Gynecology Reproductive

Biology. 2020;254:119-23. https://doi.org/10.1016/

j.ejogrb.2020.08.038.

Jenabi E, Salimi Z, Bashirian S, Khazaei S, Ayubi E.

The risk factors associated with placenta previa: An

umbrella review. Placenta. 2022 Jan;117:21-27. DOI:

1016/j.placenta.2021.10.009.

Durukan H, Durukan ÖB, Yazıcı FG. Planned versus

urgent deliveries in placenta previa: maternal,

surgical and neonatal results. Archives of

Gynecology Obstetrics. 2019;300:1541-9.

https://doi.org/10.1007/s00404-019-05349-9.

Argote-Ríos MD DF, Zapata-Salazar MD LF,

Martínez-Ruíz MSc D, Sinisterra-Díaz MD SE,

Sarria-Ortiz MD D, Nieto-Calvache MD AJ.

Maternal outcomes according to the type of placenta

previa in a high complexity hospital in Cali,

Colombia. Retrospective cohort study. Revista

Colombiana de Obstetricia y Ginecología.

;74(1):28-36. https://doi.org/10.18597/

rcog.3852.

Kang J, Kim HS, Lee EB, Uh Y, Han K-H, Park EY, et

al. Prediction model for massive transfusion in

placenta previa during cesarean section. Yonsei

Medical Journal. 2020;61(2):154-60.

https://doi.org/10.3349/ymj.2020.61.2.154.

Melcer Y, Jauniaux E, Maymon S, Tsviban A, Pekar

Zlotin M, Betser M, Maymon R. Impact of targeted

scanning protocols on perinatal outcomes in

pregnancies at risk of placenta accreta spectrum or

vasa previa. Am J Obstet Gynecol. 2018

Apr;218(4):443.e1-443.e8. DOI: 10.1016/

j.ajog.2018.01.017.

Naz M, Yousaf M, Pervaiz MQ, Tariq A, Ahmad UR,

Mushtaq A. Sonographic Assessment of Placenta

Previa with and without History of Cesarean Section

or Abortion. Pakistan Journal of Medical Health

Sciences. 2022;16(07):559-. https://doi.org/

53350/pjmhs22167559.

Jansen CH, Kleinrouweler CE, van Leeuwen L,

Ruiter L, Limpens J, van Wely M, et al. Final outcome

of a second trimester low-positioned placenta: A

systematic review and meta-analysis. European

Journal of Obstetrics Gynecology Reproductive

Biology. 2019;240:197-204. https://doi.org/

1016/j.ejogrb.2019.06.020.

Ward S, Sun Z, Maresse S. Placental cord insertion

migration: Implications for ultrasound

documentation and follow‐up of abnormal placental

cord insertion site. Australasian Journal of

Ul t r a s o u n d in Medicine. 2024.

https://doi.org/10.1002/ajum.12399.

Ndomba M, Mukuku O, Tamubango H, Biayi J,

Kinenkinda X, Kakudji P. Risk Factors and

Outcomes of Placenta Praevia in Lubumbashi,

Democratic Republic of Congo. Austin Journal of

Pregnancy & Child Birth. 2021;2(1):1002.

https://doi:10.26420/AustinJPregnancyChildBirth.2

1002.

Park H-S, Cho H-S. Management of massive

hemorrhage in pregnant women with placenta previa.

Anesthesia Pain Medicine. 2020;15(4):409-16.

https://doi.org/10.17085/apm.20076.

Li X, Feng Y. Complete placenta previa in the second

trimester: clinical and sonographic factors associated

with its resolution. Ginekol Pol. 2019;90(9):539-543.

doi: 10.5603/GP.2019.0093. PMID: 31588552.

Jansen C, Kleinrouweler C, Kastelein A, Ruiter L,

Van Leeuwen E, Mol B, et al. Follow‐up ultrasound

in second‐trimester low‐positioned anterior and

posterior placentae: prospective cohort study.

Ultrasound in Obstetrics Gynecology.

;56(5):725-31. https://doi.org/10.1002/

uog.21903.

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Published

2025-03-31

How to Cite

Ayesha Saif, Zunaira Hafeez, Sadia Ilyas, Muhammad Ali Rauf, Shadia Shah, Nabeela Shami. Migration of Placenta Previa in Patients Presenting in A Tertiary Care Hospital and Feto-maternal Outcome. Esculapio - JSIMS [Internet]. 2025 Mar. 31 [cited 2025 May 13];21(1):105-9. Available from: https://esculapio.pk/journal/index.php/journal-files/article/view/1223