Hysterectomy in the 33rd Week of Pregnancy Due to Placenta Praevia – A Severe Obstetric Complication Despite Correct Diagnosis

Abstract:Placenta praevia is one of the leading causes of maternal morbidity and mortality. The incidence of placenta praevia is from 0.1 to 1.0% of all births. Postpartum haemorrhage (PPH) is the most common cause of maternal death and is responsible for one-quarter of maternal deaths globally, approximately for 140,000 deaths annually. Obstetric haemorrhage can occur at any stage of pregnancy. In early pregnancy the major causes of bleeding are ectopic pregnancy, incomplete abortion and trauma. In the second half of pregnancy and during labour the most common causes of bleeding are placenta praevia, placental abruption and uterine rupture, including scar dehiscence after previous operations. The causes of postpartum bleeding are uterine atony, haemorrhage from the space of incorrectly nested placenta, infections, bleeding disorders, injuries and damage to the birth canal. Haemorrhage in the second half of pregnancy relates to 4% of pregnant women and they are most often related to abnormalities of the placenta. More than half of the cases are due to placenta praevia (22%) and improper localization of the placenta (31%). The study presents the case of postpartum haemorrhage and hysterectomy performed in a 30-year-old woman at 33rd week of pregnancy with placenta praevia.

Authors:

Monika E. Dzwigala, Agnieszka Dobrowolska-Redo, Ewa Romejko-Wolniewicz

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