Abstract

The overall prevalence of abruptio placenta in pregnancy is estimated to be 0.4-1%. Even though it is low prevalence, in developing countries this condition is one of leading causes of all deaths that occur during the perinatal period. Objective: To study risk factors, maternal and perinatal outcome in diagnosed cases of Abruptio Placenta Methods: A hospital based prospective study was carried out over a period of two years among 55 cases of abruptio placenta. Detailed history, clinical examination and investigations were carried out. Apart from assessing maternal and neonatal complications, Sher-Statland classification was used to grade the severity of cases of abruptio placenta. Results: In this study, majority of pregnant women (74.5%) with abruptio placenta were of the age group 20-25 years and most of them were near term i.e., around 33-36 weeks of gestation. Vaginal bleeding was the most common presenting symptom (74.5%) and anemia was most common associated risk factor (74.5%) in the women diagnosed with abruption. Almost 91% of these women were unbooked with no regular or poor antenatal check-ups and in most of them, abruption was so severe to cause intra-uterine fetal death (61.8%). Mortality rate among the neonates was 14.5% in the present study. Most common maternal complication observed was acute kidney injury (14.5%) and no maternal mortality was observed in this particular study. Conclusion: Acute kidney injury was the most common maternal complication observed. Though neonatal mortality rate is comparatively low among the cases of this study, intra-uterine death was the most common fetal outcome, especially amongst the pregnant women with no prior ANC. Anemia and hypertension were the two most associated risk factors for placental abruption. Early identification of risk factors on regular ANC and timely intervention of the diagnosed abruption cases, would reduce both maternal and perinatal morbidity & mortality.

Description