Foeto-Maternal Outcome Of Abruptio Placentae at a Tertiary Care Hospital

Abstract

Objective: To determine the frequency, risk factors and, maternal and perinatal outcome in women presenting with abruptio placentae at a tertiary care hospital. Methodology: This observational, descriptive study was conducted in the Department of Obstetrics and Gynecology Unit I, Jinnah Postgraduate Medical Centre (JPMC), Karachi from January 2011 to December 2013. All pregnant women with gestational age 28 weeks or greater, having retro-placental clots on ultrasound and/or painful vaginal bleeding were included by using nonprobability purposive sampling technique. Results:There were 24,591 obstetric admissions during the study period, and 21,669 of them delivered. Of these 489 were diagnosed as abruptio placentae, making it a condition with a frequency of 1.98% of obstetric admissions and 2.25% of deliveries. 394 of the 489 cases (80.6%) were un-booked. Majority of them (252, 51.5%) were grand multipara with mean parity of 4.8 ± 3.3. 330 (61.4%) were older than 30 years (36.1± 12.6 years). 392 (80.2%) delivered vaginally and the rest 97 (19.8%) were delivered by Caesarean section. Hypertension and pre-eclampsia were collectively seen in 124 (25.2%), anaemia in 77 (15.7%), smoking in 39 (7.9%) and trauma in 8 (1.6%) patients. Noteworthy maternal complications were postpartum haemorrhage (PPH) in 70 (14.3%), postpartum anemia in 55 (11.2%), disseminated intravascular coagulation in 13 (2.65%) and renal failure in 2 (0.4%) patients. Maternal death occurred in 17 (3.5%) women. Still birth occurred in 194 (39.7%) patients. Perinatal Mortality was 68.7%. Conclusion: Abruptio placenta has a significantly increased risk of maternal and perinatal mortality. Risk factors include multiparity, hypertension, pre-eclampsia, anaemia and smoking