Musarrat Jabeen, Fouzia Gul.
Abruptio Placentae: risk factors and perinatal outcome.
J Postgrad Med Inst Jan ;18(4):669-76.

Objective: To determine the risk factors and maternal and fetal outcome of placental abruption. Material and Methods: This study was conducted in the department of Gynae/Obs PGMI LRH, Peshawar over a period of one year. Patients with abruption were confirmed by the presence of retroplacental clots or the depression of underlying placental tissues. All the details of the history, physical examination of women, investigations and particularly details of delivery, baby and postpartum period were recorded. Results: During the study period of one year, 3291 deliveries were conducted and 151 cases of placental abruption were found, constituting the incidence ratio of 4.5%. Out of 151 cases, 80 patients (52.9%) were multigravida and 64 cases (42.3%) were multigravida. One hundred and eleven cases (73.5%) were more than 35 years of age. History of smoking and naswar was present in 4 cases (2.6%) and 7 cases (4.63%) respectively. Five cases (3.31%) had history of trauma. Twenty patients (13.2%) had history of chronic hypertension, 30 cases (19.86%) were diagnosed as preeclampsia and 5 cases (3.31%) had eclampsia. Anemia was present in 130 cases (86.07%). Twenty six cases (17.2%) had more than 1500 ml of clots. Five cases (3.3%) had premature rupture of membranes. Seven patients (4.63%) had multiple pregnancies. Out of 158 babies delivered, 78 (49.36%) were alive and 80 (50.63%) were stillbirth. Forty six (29.1 %) of the babies were low birth weight babies and 12 babies (7.59%) were having congenital anomalies. Common maternal complications were DIC in 25 cases (16.5%) and postpartum hemorrhage in 22 (14.57%) cases. Two patients (1.32%) died of placental abruption. Conclusion: Abruptio placentae is common in women with advancing age, high parity, hypertensive disorders of pregnancy and smoking. Abruptio placentae is a major risk factor for maternal and foetal morbidity and mortality.

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