A study of risk factors and maternal and fetal outcome in patients with abruptio placentae

Objectives: To determine the risk factors and to find out the obstetric and perinatal outcome in patients with placental abruption.
Study Design:- Prospective Observational Study.
Materials and Methods: The present study was conducted in Department of Obstetrics and Gynaecology, Government Medical College and Rajindra Hospital Patiala from January 2017 to December 2017. All the patients presenting as antepartum hemorrhage in 3rd trimester underwent detailed history and examination. Those cases diagnosed as abruptio placentae were included in the study. Maternal and perinatal outcome and risk factors were noted.
Results: In the study period 176 patients were diagnosed as abruptio placentae. Incidence of abruption placenta came out to be 3.8%.Most (70.5%) of the cases were unbooked with average age 21-25 years and 67.6% patients were from lower socio economic class. Anaemia was observed in 83.5% of patients, pregnancy induced hypertension in 58.5% of cases, Gestational diabetes mellitus in 5.1% cases and premature rupture of membrane in 13.1%. 57.3% of cases were delivered by LSCS, 38.6% had vaginal delivery and 3.9% underwent assisted breech vaginal delivery. Maternal complications observed were post-partum hemorrhage in 24.4% cases, puerperal sepsis 15.3% cases, hemorrhagic shock in 14% cases, 7.4% cases needed mechanical ventilation, 6.2% cases had disseminated intravascular coagulation and 3.4% cases went into acute renal failure. There were 3(1.7%) maternal deaths. 37.5% babies were born alive, while 62.5% babies were still born. Out of 66 live born (37.5%) babies, 13 babies died due to prematurity thus making total perinatal mortality 69.9%.
Conclusion: We observed a higher than expected frequency of abruptio placentae and neonatal mortality in our study population which is of major concern. There is need for mass information regarding the importance of antenatal care and improvement in nutritional status, which may reduce the frequency of maternal and fetal morbidity and mortality associated with abruptio placentae.