one of the greatest obstetric emergencies is antepartum haemorrhage, one of which is abruptio placenta. It is important as it occurs suddenly and is associated with both maternal and fetal morbidity and mortality worldwide. In developing countries, including India with poor resource setting, the situation is worse. This study is aimed to determine the risk factors for abruptio placenta and subsequent feto-maternal outcome in a tertiary care government hospital.
Methods: A prospective observational study was conducted at department of obstetricand gynaecology, GMERS Medical College and Hospital, Ahmedabad. All patients admitted with antepartum haemorrhage in third trimester were examined and analysed, and only those patients diagnosed with abruptio placenta clinically and/or sonographically were included in the study. The maternal complications and fetal outcome were analyzed in detail.
Results:In the study period, 46 women were diagnosed with abruptio placenta. Incidence of abruptio placenta came out to be 1.09% at our institute. It is more common in the women of age group 25- 35 years and 39.1% cases were strongly associated with gestational hypertension. The incidence is increased to 69.5% in multigravida patients. Live birth rate was 63.1 % and still birth was 36.9%. Postpartum haemorrhage (19.5%), acute renal failure (17.3%), disseminated intravascular coagulation (13%.0) is the most common complication occurring in abruption. The most common indication for cesarean section was fetal distress (50.0%).
Conclusion: Abruptio placenta is associated with poor maternal and especially poor fetal outcome. Gestational hypertension is strongly associated with abruption. There is need to spread awareness regarding taking adequate antenatal care so that the associated risk factors could bediagnosed early and treated adequately. Prompt resuscitative measures and expedition of delivery process after abruption favours good feto-maternal prognosis.