Rahat Jabeen, Ilyas Siddiqi.
Frequency, Risk Factors and Feto-Maternal Outcome in Abruptio Placenta Cases.
Ophthalmol Update Jan ;12(3):221-4.

Background: Abruptio placentae remain a major cause of perinatal morbidity and mortality globally, though of most serious concern in the developing world. Placental abruption complicates about 1% of pregnancies and is a leading cause of vaginal bleeding in the latter half of pregnancy. Objective: To determine the frequency, risk factors and feto-maternal outcome of abruptio placentae at our setup. Materials and Methods: This is an observational prospective study conducted at obstetrics and gynaecology department of Hayatabad Medical Complex, Peshawar during one year from June 2012 to June 2013. All patients with diagnosis of abruptio placenta and gestational age of >24 weeks were included in the study. Women having bleeding due to causes other than abruption like placenta previa, vasa previa, carcinoma cervix and other local lesions were excluded. All the data collected through history, examination and investigations were recorded on a predesigned proforma. Data were analysed using SPSS version 10.0 and results were analysed by calculating percentages. Results: A total of 122 cases of abruptio placentae were recorded out of 2845 cases admitted for delivery during the study period constituting the incidence ratio of 4.2%.About 52 women (42.6%) were in the age group of 25-30 years and 44 (36%) women were more than 30 years of age (Table-I). Incidence was higher in multi-parous, being 87 (71.4%) Table 1. A total of 76(62.2%)women were anaemic. Pregnancy induced hypertension was seen in fourteen(11.4%), diabetes in eight(6.5%) and multiple pregnancy in eleven (9%). No risk factor was present in 13(10.6%) women Table 2. As regards mode of delivery, 85(69.6%) women delivered spontaneously vaginally and 37(30.3%) underwent caesarean section. Four patients died undelivered cause being severely anaemic, shock and disseminated intravascular coagulation (DIC). Major maternal complication seen was hypovolemic shock in 36(29.5%), followed by postpartum haemorrhage in 17(14%), altered coagulation profile in 7(5.7%) and renal failure in 5(4%) of patients. Maternal mortality was 3.2%. About 80(65.5%) women delivered alive babies while 42(34.4%) were stillborn. Out of 80 alive born, five died within first week of birth due to prematurity. Overall perinatal mortality was 38.5% and maternal mortality was 3.2%. Conclusion: Abruptio placenta is common in women with high parity, advancing age, hypertensive disorders of pregnancy and smoking. It is associated with high rate of maternal and fetal morbidity and mortality. Antenatal care plays an important role in decreasing the incidence of abruptio placenta.

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