Abruptio Placentae- Vigilance Needed!

Abstract

BACKGROUND Antepartum Haemorrhage (APH) is an obstetric emergency, contributing to a significant amount of maternal & perinatal morbidity and mortality. In Abruptio placentae (Accidental haemorrhage), bleeding occurs due to premature separation of normally situated placenta and it contributes to nearly one third of APH cases. Early evaluation of risk factors to prevent abruption is needed.The aim of this study is to evaluate how far we have come and the effect of such treatment on the perinatal and maternal outcome. MATERIALS AND METHODSPresent study was carried over the period of 2 years at Indira Gandhi Government Medical College, Nagpur. 68 women with gestational age more than 28 weeks of abruptio placenta came during this period. Detailed clinical, sociodemographic and obstetric history was taken and cases managed as per their clinical presentation. Maternal and perinatal complications studied and analysed. RESULTS 69.11% were unbooked and abruption was more in multiparous, and in gestational age of more than 36 weeks (60.29%). It was associated more with PIH (Pregnancy-induced hypertension) 52.94%, 21 (30.88%) cases presented with no foetal heart sound but 14 were of foetal distress. 30 women delivered by caesarean section of which 7 had Couvelaire changes in uterus. Foetal outcome varies with the gestational age, out of 68 women of abruption, only 7 were stillbirths and 7 were early neonatal deaths due to severe prematurity and 1 maternal mortality. CONCLUSIONTimely diagnosis and intervention is necessary in APH. PIH is a most common factor which reflects poor antenatal care. It should be made mandatory for all primary health centres to identify high-risk patients at their level and timely referral to tertiary care centres.