Abstract: Objectives: Any bleeding from the genital tract during pregnancy, after the period of viability until the delivery of the fetus, is defined as antepartum hemorrhage. The World Health Authority defines antepartum hemorrhage is bleeding after 28 weeks of pregnancy. Maternal and newborn health care are closely linked. Almost 3 million newborn babies die every year and additional 2.6 million babies are stillborn. With improvement in medical facilities, early diagnosis, availability of blood products, anesthesia, hospital deliveries, proper timely reference, proper management of shock along with liberalization of cesarean section, the rate of maternal morbidity and mortality is gradually decline.
Methods: This study of 84 cases of Antepartum hemorrhage cases were admitted during the period of May 2012 to May 2013 in Dhiraj General hospital, a tertiary care hospital situated in rural area of Vadodara. Singleton pregnancy with gestation age 28- 42 weeks patients were included in the study.
Results: In present study incidence of Antepartum hemorrhage is 2.86% and of the 84 cases 44 were of placenta previa and 40 cases were of abruptio placenta. In this study 85.2% were emergency cases. Incidence of APH was 62% in age group of 25-34 years of which 71% were multipara. Ultrasonography was very much useful in diagnosis of placenta previa (100%), while most of cases (70%) o abruptio placenta were diagnosed clinically. At the time of admission 60.7% were anaemic and required blood transfusion. The perinatal mortality rate of abruptio placenta is 72.5% and placenta previa is 27.2%. Neonatal morbidity was high in APH because of prematurity and its complications. This increased the NICU admission.
Conclusion: Awareness of pregnant mothers about the importance of regular antenatal care and easy accessibility to quality antenatal services would go a long way in bringing down the maternal and perinatal morbidity and mortality related with APH. The morbidity associated with placenta previa can be reduced by detecting the condition of placenta in antenatal period by ultrasound and also the correction of anaemia during antenatal period. Intensive family planning programs helps in decreasing cases of APH in relation with age and parity. Efforts should be made to reduce the rate of unnecessary abortion, septic abortions, operative deliveries, because there is greater likelihood of placenta previa in scarred uterus. From present study it can be concluded that APH is still a leading cause of maternal morbidity and mortality in our country.
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