MATERNAL AND FETAL OUTCOME AMONG ABRUPTIO PLACENTAE CASES IN A RURAL TERTIARY HOSPITAL IN MAHARASHTRA, INDIA; A PROSPECTIVE OBSERVATIONAL STUDY

Dr. Sushma Gore, Dr. Rohidas Chavan, Dr. Prakshal Shah

Abstract


Background: Placental abruption complicates about 2-5% of pregnancies and is a leading cause of vaginal bleeding in the latter half of pregnancy. It is also an important cause of perinatal and maternal mortality and  morbidity. The maternal effect of abruption depends primarily  on its severity, whereas its effect on the fetus is determined both by its severity and the gestational age at which it occurs. The Diagnosis was confirmed on the presence of retroplacental clot, which was used to estimate the amount of bleeding and severity of abruption. Patients were managed according to the fetal and maternal conditions and ultrasonography.

Methods: The study was carried out for a period of one year from 1st July 2018 to 30th June 2019. The study population included all cases of antepartum haemorrhage, confirmed as abruption post delivery were included and other causes like placenta previa, other extraplacental causes were excluded in this study who came to the Department of Obstetrics and Gynecology during the study period. Subjects selected for the study were all cases diagnosed as having abruptio placentae.

Results:

 Total number of women admitted in labor ward between 1st July 2018 to 30th June 2019 were 8551. Among these 122 had abruptio placentae. Majority of patients were in the age group 25-30 years. Incidence was higher in multi-parous. Spontaneous vaginal delivery was the mode in most patients (~69.6%). Major maternal complications seen were anaemia in 33(27%), shock in 18(14.7%), post partum haemorrhage in 10 (8.1%), altered coagulation profile in 4 (3.2%) of patients.  72.97% women delivered alive babies while 27.03% were stillborn.

Conclusion: Resuscitation and termination is gold standard treatment for abruptio placenta. Abruptio placenta is associated with high rate of maternal and fetal morbidity and mortality, Because of this association, the conditions predisposing it should be carefully evaluated in order to reduce the occurrence of placental abruption. Unfortunately neither accurate prediction nor prevention of abruption is possible at the present time. Despite advances in medical technology, the diagnosis of abruption is still a clinical one.


Keywords


Abruptio placentae, Retroplacental clot

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