Objective
To determine maternal and fetal morbidity with abruptio placentae and its outcome in these patients.
Patients and Methods
This cross-sectional study was conducted in the department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre (JPMC) Karachi, from February 2007 to January 2009. After ruling out other causes of antepartum hemorrhage, 50 patients of abruptio placentae after 20 weeks gestation admitted to labor ward were included in the study. Various maternal and fetal complications were noted.
Results
Only 10 (20%) patients were booked at JPMC for delivery and remaining 40 (80%) patients were non-booked and were admitted through emergency. Anemia was found in 22 (44%) patients, renal failure in 3 (6%) and disseminated intravascular coagulopathy in 5 (10%) patients. In 3 (6%) patients abruption had occurred in previous pregnancy. Hypertension was the most common associated risk factor found in 44% patients. Anemia, multiparity and advanced maternal age was also strongly associated with abruption. Placental abruption was more common in age group 31-40 years and grandmultipara (>P5). Forty (80%) patients had vaginal deliveries while in 10 (20%) patients caesarean section was performed; out of these one had caesarean hysterectomy due to life threatening PPH. Couvelaire uterus were found in 3 (6%) patients and PPH occurred in 14 (28%) patients. 70% patients received blood transfusion with quantity ranging between 1-5 pints, FFP ranging between 0-6 pints. No maternal death was seen. Out of 50 births, 18 (36%) babies were born alive, 25 (50%) babies were stillbirths and early neonatal death occurred in 7 (14%). Perinatal mortality was 64%.
Conclusion
Placental abruption can result in significant morbidity in both mother and fetus. (Rawal Med J 2011;36:297-300).
Key words: Maternal morbidity, abruptio placentae, antepartum hemorrhage.
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