A Study of Antepartum Hemorrhage and Its Maternal and Perinatal Outcome at Tertiary Care Hospital in Western Rajasthan

Abstract

Background: Antepartum hemorrhage is an obstetric emergency contributing to a significant amount of perinatal & maternal morbidity and mortality. The main causes of APH are placenta previa, abruptio placentae, indeterminate cause or local causes of genital tract. APH complications can be fetal as well as maternal. The maternal complications are malpresentation, premature labor, postpartum hemorrhage, sepsis, shock and retained placenta. Various fetal complications are prematurity, low birth weight, intrauterine death, congenital malformation and birth asphyxia. Objective: To study maternal and perinatal outcome in patients of APH at a tertiary care referral hospital in Western Rajasthan. Material and Methods: This was a retrospective observational study conducted over a period of one year. A total of 112 cases of APH were studied. The diagnosis of all cases was made on the basis of history, clinical examination and ultrasonography. All the cases of hemorrhage were grouped as: Placenta Previa, Abruptio Placenta or other causes. Results: Out of 8623 deliveries, 112 had APH, incidence being 1.29%. Maximum number of cases about 86(76.8%) were of placenta previa followed by abruptio placentae in 23 cases (20.5%) and the least was unclassified hemorrhage 3(2.7%). The incidence of APH was highest 43.8% in the age group 25-29 years. Anemia was the most common complication (51.7%) in APH patients. Neonatal jaundice was the most common complication (26.8%) amongst the neonate of APH. Conclusion: High incidences of APH are associated with iron deficiency anemia and lack of awareness in India. Maternal and perinatal morbidity and mortality could be prevented by early regular antenatal care, improved nutritional status, better antenatal services, increased awareness, and timely caesarean section.

A study of risk factors and obstetric outcome of antepartum haemorrhage in a tertiary care hospital of eastern India

“…From the literature review, Yadav et al 4 reported in their study that 25-29 years' age were commonest age group in their study which was quite similar to our study. In their study, placenta praevia, abruptio placentae and unclassified variety were 76.8%, 20.5% and 2.7% respectively.…”

“…A study conducted by Yadav MC et al 4 found neonatal jaundice was present in 26.8% of APH but among the women of placenta praevia it was present in each (30/30) new-born. Their findings were contradictory with the finding of our study, that may be due to study conducted in different geographical locations, or may be due to there was small sample size.…”

“…the period of viability. 1,3,4 On an average 0.5 to 5% of all pregnancies are complicated by antepartum and multiparty. Exact cause of placental abruption is unknown but often were associated with preeclampsia, pre-labour rupture of membrane and abdominal trauma, cigarette smoking.…”

“…5 Foetal complications include prematurity, neonatal jaundice, intrauterine death, still birth and perinatal mortality. 4 The developed world has already reduced maternal mortality from APH by implementing small family norms with increased family planning acceptances, availability of institutional delivery and sophisticated neonatal care units.…”

Identifying the risk factors of antepartum haemorrhage and to evaluate the feto maternal outcome in antepartum haemorrhage cases

“…Similar results were seen in study conducted by Yadav et al in 2019 which shows 76.8% cases were of placenta previa followed by 20.5% cases of abruptio placenta and rest 2.7% cases were unclassified. 9 In our study 86% of the patients were below 30 years age, which was similar to the result reported by Sharma et al and Rajoriya et al in which the 72% and 51.2% cases of APH were belonged to aged 26-30 years. 10,11 Similar results were reported by Das et al, Abbasi et al also reported the mean age 30 years.…”