title: Factors associated with placenta praevia in primigravidas and its pregnancy outcome.
abstract: OBJECTIVE
  To examine the factors associated with placenta praevia in primigravidas and also compare the pregnancy outcomes between primigravidas and nonprimigravidas.
  
  
  METHODS
  A retrospective cohort study was conducted in women who underwent caesarean section for major placenta praevia in a tertiary university hospital from January 2007 till December 2013. Medical records were reviewed.
  
  
  RESULTS
  Among 243 with major placenta praevia, 56 (23.0%) were primigravidas and 187 (77.0%) were nonprimigravidas. Factors associated with placenta praevia in the primigravidas were history of assisted conception (P = 0.02) and history of endometriosis (P = 0.01). For maternal outcomes, the nonprimigravidas required earlier delivery than primigravidas (35.76 ± 2.54 weeks versus 36.52 ± 1.95 weeks, P = 0.03) and had greater blood loss (P = 0.04). A vast majority of the primigravidas had either posterior type II or type III placenta praevia. As for neonatal outcomes, the Apgar score at 1 minute was significantly lower for the nonprimigravidas (7.89 ± 1.72 versus 8.39 ± 1.288.39 ± 1.28, P = 0.02).
  
  
  CONCLUSIONS
  This study highlighted that endometriosis and assisted conception were highly associated with placenta praevia in primigravida. Understanding the pregnancy outcomes of women with placenta praevia can assist clinicians in identifying patients who are at higher risk of mortality and morbidity. Identifying potential risk factors in primigravida may assist in counseling and management of such patients.
authors.affiliation: Department of Obstetrics & Gynaecology, UKMMC, Jalan Yaacob Latiff, 56100 Kuala Lumpur, Malaysia.
authors.forename: Abdul Ghani
authors.initials: AG
authors.lastname: Nur Azurah
authors.affiliation: Department of Obstetrics & Gynaecology, UKMMC, Jalan Yaacob Latiff, 56100 Kuala Lumpur, Malaysia.
authors.forename: Zakaria
authors.initials: Z
authors.lastname: Wan Zainol
authors.affiliation: Department of Obstetrics & Gynaecology, UKMMC, Jalan Yaacob Latiff, 56100 Kuala Lumpur, Malaysia.
authors.forename: Pei Shan
authors.initials: PS
authors.lastname: Lim
authors.affiliation: Department of Obstetrics & Gynaecology, UKMMC, Jalan Yaacob Latiff, 56100 Kuala Lumpur, Malaysia.
authors.forename: Mohd Nasir
authors.initials: MN
authors.lastname: Shafiee
authors.affiliation: Department of Obstetrics & Gynaecology, UKMMC, Jalan Yaacob Latiff, 56100 Kuala Lumpur, Malaysia.
authors.forename: Nirmala
authors.initials: N
authors.lastname: Kampan
authors.affiliation: Department of Obstetrics & Gynaecology, UKMMC, Jalan Yaacob Latiff, 56100 Kuala Lumpur, Malaysia.
authors.forename: Wan Syahirah
authors.initials: WS
authors.lastname: Mohsin
authors.affiliation: UKM Molecular Biology Institute, Jalan Yaacob Latiff, 56100 Kuala Lumpur, Malaysia.
authors.forename: Norfilza Mohd
authors.initials: NM
authors.lastname: Mokhtar
authors.affiliation: Department of Obstetrics & Gynaecology, UKMMC, Jalan Yaacob Latiff, 56100 Kuala Lumpur, Malaysia.
authors.forename: Muhammad Abdul Jamil
authors.initials: MA
authors.lastname: Muhammad Yassin
mesh_terms: D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D005260:Female; D020073:Gravidity; D006801:Humans; D010923:Placenta Previa / Q000473:pathology / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors