Abruptio placentae: Epidemiology and pregnancy outcome in a low-resource setting

Abstract

Background: Abruptio placentae are a life-threatening obstetric emergency associated with high maternal, foetal and neonatal morbidity and mortality. Aim: The aim of this study is to determine the modes of presentation, management and pregnancy outcome of pregnancies complicated by abruptio placentae at a tertiary health facility. Methods: A descriptive study (retrospective) of women managed for abruptio placentae over a period of 3 years. The inclusion criteria were diagnosis of abruptio placentae (clinical or radiological), delivery at the study site and availability of the case files for review. Exclusion criteria included patients with other conditions except abruptio placentae, delivery at other facilities or failure to retrieve the case files. Data collection was from the case files of participants, and the results were represented in tables. Results: Out of 8,931 deliveries during study , 64 had for abruptio placentae (prevalence 0.72% or 7.2/1000); however, 60 satisfied the inclusion criteria and were included in subsequent analysis. Twenty (33.3%) were above 35 years old, 14 (23.3%) were grandmultipara and the most common risk factor was hypertensive disorders (26; 43.3%). Thirty (50.0%) presented with vaginal bleeding, retroplacental clot was present at delivery in 27 (45.0%), 37 (61.7%) had emergency abdominal delivery, 51 (85.0%) had anaemia at presentation while 37 (61.6%) had blood transfusion. Forty-four (73.4%) were preterm (mean gestational age 35 ± 2.9 weeks) and neonatal survival was 50.0%; among survivors, 25 (83.3%) required neonatal intensive care due to perinatal asphyxia. Perinatal mortality was 50% (500/1,000), but no maternal death among study participants. Conclusion: Abruptio placentae remain a potential cause of maternal, foetal and neonatal complications; however, emergency caesarean delivery appears to improve neonatal survival in complicated cases with live foetuses.