Nabila Khan, Samina Jadoon, Naseem Akhtar.
Frequency and Maternal Outcome Following Placental Abruption.
J Saidu Med Col Jan ;8(2):156-60.

Background: Placental abruption is one of the leading causes of antepartum hemorrhage in third trimester. It is associated with significant maternal and fetal morbidity and mortality. Objective: To determine the maternal morbidity and mortality following placental abruption. Material And Methods: A descriptive retrospective study was conducted at Gynae B Unit, Mardan Medical Complex, Mardan and duration of study was from January2015 to March 2017. Maternal complications like disseminated intravascular coagulation, Hypovolemic shock, postpartum hemorrhage, renal failure, respiratory distress syndrome, hysterectomy and in hospital death were taken into account. Results: The results of our study revealed that most of the women were in age group of (25 -35)with mean age at 31.35.Two third of them belonged to poor socioeconomic status. 80% of patients had no previous antenatal record. Incidence was higher in multigravidas and hypertensive women.98% presented with vaginal bleeding and 54% were in labor. Most of them 65% delivered vaginally and 35% underwent C-section.Major maternal complications occurred in 52% cases. The most common maternal complication was anemia in 87(87%) of cases.23(23%) patients had primary postpartum hemorrhage and the cause of hemorrhage was uterine atony in 17(17%) cases and abnormal clotting profile in 6(6%) cases. Hypovolemic shock was present in 9(9%).Disseminated intravascular coagulation was seen in 6(6%),Renal failure requiring hemodialysis in 3(3%), hysterectomy for controlling life-threateningpostpartum hemorrhage in 10(10%) while maternal death occurred in 1(1%) patient. Conclusion: In conclusion placental abruption is a serious and unpredictable Obstetric condition compromising maternal health and wellbeing. Early diagnosis, prompt delivery of fetus with appropriate multidisciplinary management and early intervention can limit maternal complications and mortality. However it was found that cesarean section increased maternal morbidity by increasing risk of obstetrical hysterectomy at C-section as compared to women delivered vaginally.

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