A Retrospective Analysis of Antepartum Haemorrhage at Ain Shams University Hospital

Abstract

Background: Antepartum haemorrhage (APH) can be described as a malicious phenomenon that is lying in wait to send their patients straight to the grave if it was not taken seriously from the start. Therefore, it has always been considered one of the commonest leading causes of maternal and perinatal morbidity and mortality. APH is defined as any bleeding from or into the genital tract after the period of viability and before the delivery of the baby. The aim of the current study was to assess maternal and neonatal outcome in patients with antepartum haemorrhage, prevalence of their different types, the associated risk factors and complications, and the different lines of management that were implemented. Methods: The present study was a retrospective observational study undertaken in the Obstetrics and Gynaecology department of Ain shams University Maternity and Women's Hospital, during a period of 3 months from August 1st, 2020 to October 31st, 2020. Total number of patients recorded were 99 cases of antepartum haemorrhage who have fulfilled the inclusion criteria. Data was recorded on the MS excel sheet for further analysis and processing using statistical package for social science, version 20.2 (SPSS inc., Chicago, Illinois, USA). Results: Total 3063 cases were registered during this period out of which 99 presented as APH and incidence of APH was found to be 3.23%. Placenta previa (67.68%) was the most common type of APH followed by placenta accreta (34.34%) and accidental haemorrhage (30.30%). The mean age of most women was 30.53±6.08 years and the mean gestational age was 34.96±2.96 weeks. High risk factors included previous Lower Segment Caesarean Section (LSCS), previous Dilation and Curettage (D&C), hypertension, multiple pregnancies and mal-presentations. Most of the patients underwent preterm LSCS (61.62%) but 8.08% performed caesarean hysterectomy. Neonatal Intensive Care Unit (NICU) admissions recorded were 26.26%. Most fetal complications were due to prematurity. 66.6% of the patients required blood transfusion. Overall perinatal mortality was 5.05% and maternal mortality was zero. Conclusion: Women with APH have to be considered as high-risk pregnancy and need institutional supervision. Early diagnosis and management of the condition along with trained team of doctors are considered key strategies in avoiding APH related maternal, fetal and neonatal complications.