Abstract
Background: Bleeding that takes place after premature separation of the normally situated placenta, usually after 20 weeks of pregnancy, is known as abruptio placenta. Factors increasing chances of abruptio placenta are advanced age pregnancy, parity, smoking, pregnancy-induced hypertension, pre-eclampsia, and previous incidence of abruptio. The objective of the study was to find the frequency of abruptio placenta in women with pregnancy-induced hypertension.Methods: This descriptive prospective study was conducted in the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Karachi, from January to July, 2021. Women of gestational age above 20 weeks were included. Patients with blood pressure ≥140/90mmHg were considered as having pregnancy-induced hypertension. Early separation of the normally placed placental from the uterine wall was defined as placental abruption with clinical signs of painful vaginal bleeding (concealed or revealed), uterine contractions, and non-reassuring fetal heart rate. Descriptive statistics were calculated. Stratification was done and the post-stratification chi-square test was applied. P-value ≤ 0.05 was taken as significant.Results: A total of 205 patients were included in the study. The mean age was 24.26±2.92 years. The mean gestational age was 30.82±3.22 weeks. The mean parity was 2.59±0.80 children. Mean systolic blood pressure was 148.48±5.99 mmHg and mean diastolic blood pressure was 94.85±3.05 mmHg. Bleeding was reported in 110 (53.7%) cases. Lower abdominal tenderness in 125 (60.5%) cases. Fetal heart rate was normal in 16.6% of the cases. Abruptio placenta was observed in 29 (14.1%) patients.Conclusion:Abruptio placenta is a life-threatening condition that occurs during pregnancy that can result in both maternal and fetal morbidity and mortality. Adequate and urgent intervention can result in a favourable outcome.
Highlights
Pregnancy-induced hypertension (PIH) is the onset of new arterial hypertension in a pregnant woman after the 20th week of gestation, during labour or puerperium in previously normotensive women without the presence of protein in the urine [1,2]
This descriptive cross-sectional study was conducted at the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Karachi, for a period of six months from January 25 to July 24, 2021, after approval of the Institutional Review Board committee (F.2-81/2021-GENL/73089/Jinnah Postgraduate Medical Center (JPMC))
29 (14.1%) patients were found with abruptio placenta (AP)
Summary
Pregnancy-induced hypertension (PIH) is the onset of new arterial hypertension in a pregnant woman after the 20th week of gestation, during labour or puerperium in previously normotensive women without the presence of protein in the urine [1,2]. It occurs in about 6-8% of all pregnancies [1,3]. Painful bleeding per-vaginum may be associated with a tense tender abdomen due to concealed blood. The objective of the study was to find the frequency of abruptio placenta in women with pregnancy-induced hypertension
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