Antepartum haemorrhage (APH) has always been one of the most feared complications in obstetrics. Antepartum haemorrhage is till a grave obstetric emergency contributing to a significant amount of maternal and perinatal morbidity and mortality in our country. Haemorrhage was a direct cause of maternal death in about 30% of cases. APH complicates about 2-5% of all the pregnancies with incidence of placenta praevia (PP) about 0.33% to 0.55% and incidence of abruptio placenta (AP) about 0.5-1%. The maternal complications in patients with APH are malpresentations, premature labour, postpartum haemorrhage (PPH), sepsis, shock and retained placenta.
Aim of the study
1. To study the prevalence of antepartum haemorrhage at tertiary care hospital.
2. To assess the importance of early diagnosis and treatment.
3. To study the maternal and fetal outcome in antepartum haemorrhage.
4. To study the associated risk factors contributing to maternal and fetal morbidity and mortality.
Methodology: The study was conducted in Govt. RSRM Lying in Hospital, Chennai during the period of September 2016 to September 2017 after getting approval from the Institutional Ethical Committee.75 patients who presented at emergency OPD with APH were included in the study.
RESULTS: In the present study it was observed that the incidence of APH was more common in multipara (64%) than in nullipara. The incidence of PP was 5 times higher in multipara than primipara. Chakraborty et al. reported that prevalence of APH was higher among multigravidas. Results of present study are consistent with study of Cotton et al. who found that 83.2% of their patients with PP were multiparous and 16.78% were nulliparous. Crenshaw et al. reported that 10% patients with PP were primi gravida. Ananth et al. showed that risk of placental abruption increased with high parity.
Conclusion: All women with APH heavier than spotting and women with on-going bleeding should be recommended hospital stay atleast until the bleeding as stopped.
The pregnancy should receive consultant-led care following APH from placental abruption or unexplained APH, and serial ultrasounds for the monitoring of fetal growth are recommended.