Severe Pre-Eclamptia Resulting In Abruptio Placentae, Stillbirth and Disseminated Intravascular Coagulopathy in Antenatal Clinic Defauter Woman in Calabar, South-South Nigeria

Abstract

This case report examines a poignant instance of severe preeclampsia in a 26 year old with a history of recurrent pregnancy loss and however, a prior vaginal delivery. The patient presented at 29 weeks gestation with acute lower abdominal pain with associated abruptio placentae, resulting in a stillbirth and disseminated intravascular coagulopathy (DIC). The intricate interplay of obstetric history and clinical management reveals the challenges in navigating such complex scenarios. The patient's obstetric history of recurrent miscarriages and a vaginal delivery with perineal tear signals a predisposition to adverse outcomes. The acute presentation of abruptio placentae underscores the imperative for heightened vigilance in pregnant women even in the absence of antenatal complaints. Successful resuscitation involved correcting shock, transfusing three units of blood and addressing hemorrhagic DIC. Tranexamic acid, pentazocine, normal saline, misoprostol and oxytocin were employed to stabilize the patient, highlighting the necessity of a comprehensive and multidisciplinary approach. This case serves as a stark reminder of the unpredictable nature of severe preeclampsia and emphasizes on the critical importance of early detection and intervention. Future research endeavors should focus on refining risk stratification models and exploring innovative interventions to enhance maternal and fetal outcomes in high-risk pregnancies.