Maternal risk factors and fetal outcome in patients of abruption placentae.

Abstract

Abruption placentae are a major cause of maternal and perinatal morbidity and mortality. Placental abruption is due to the rupture of the uterine spiral artery. Bleeding into decidua leads to separation of the placenta. There are many major maternal and fetal complications associated with placental abruption. Objectives: To assess the maternal risk factors, perinatal mortality and morbidity in relation to the severity of placental abruption. Study Design: Descriptive case series. Setting: Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore for one year. Period: From Jan 2016 to Dec 2016. Material & Methods: Hundred females were included with placental abruption and were followed-up till delivery. At the time of delivery maternal and fetal complications were noted. Results: Mean age of females was 29.24 + 3.58years. The mean gestational age at delivery was 32.95+3.12 weeks. About 64% underwent vaginal delivery while 36% underwent cesarean section. Among pre-disposing factors increased risk of anemia i.e. 46%, hypertension was found in 28%, multiple pregnancies with 18% and polyhydromnias were found in 8%. The incidence of fetal mortality was 58% and only 42% were born alive at time of delivery. Fetal morbidity is analyzed, 95.23% were in need of resuscitation, admission to nursery was done in 95.23%, neonatal jaundice was seen in 80.95%, anemia in 71.42% and respiratory problems were found in 85.71%. APGAR score at 5 minutes among 21 alive born fetuses was <8 in 85.71%. Conclusion: Resultantly maternal morbidity and perinatal mortality is significant, and this calls for early detection, regular visits, and special surveillance. There should be timely referral to tertiary care center where antenatal care plays an important role in decreasing the incidence of abruption placenta.