Back ground: Abruptio placenta is a significant cause of antepartum hemorrhage (APH) and contributes to 20-25% of all APH cases. It refers to the early separation of a normally situated placenta from the uterine lining before the deliverey. APH affects 0.4-11% of all pregnancies and is a serious obstetric condition that poses a risk to both the mother and the foetus, leading to increased chances of maternal and neonatal complications and even death.
Objectives: This study aims to determine the maternal and perinatal outcomes in pregnant women with abruptio placenta by evaluating the prevalence, risk factors, socio-demographic factors, and the maternal, fetal, and neonatal outcomes at Government General Hospital, Ananthapuramu.
Materials and Methods: After obtaining permission from the Medical Superintendent of GGH, Ananthapuramu, the data was collected from the MRD section. All pregnant women admitted with vaginal bleeding and diagnosed with abruptio placenta fulfilling the inclusion criteria during the study period were included. Data on maternal characteristics such as age, parity, gestational age, presence of risk factors, mode of delivery, and complications were gathered. Perinatal characteristics like birth weight, APGAR score, NICU admission, perinatal morbidity, and mortality were also noted. The data was entered into an Excel sheet for statistical analysis.
This is a one-year retrospective observational study including all pregnant women with abruptio placenta at GGH, Ananthapuramu, a tertiary care centre, from June 2024 to June 2025.
Results: A total of 34 cases of abruptio placenta were recorded out of 7430 deliveries, giving a prevalence rate of 4.6%. The socio-demographic characteristics associated with abruption placenta includes age, booking status, parity. Highest prevalence of 51% was noted in women with age group less than 25 years. Among the pregnant women with abruptio placenta, peak prevalence was observed in the gestational age between 28 weeks to 33+6 weeks. Abruptio placenta with risk factor of pre-eclampsia were noted in 42% of cases. The cesarean section rate was 49% and normal delivery rate was 51%. There were 35% of live births, and 3% of still birth. Major complications included 62% intrauterine fetal deaths, 14% neonatal deaths, 28% anemia requiring blood transfusion, 59% postpartum sepsis, 5.9% disseminated intravascular coagulation (DIC), and one maternal death, resulting in a case-specific fatality rate of 2.9% during the study period.
Conclusion: The prevalence of abruptio placenta is not very high in our setting. However, it is a life-threatening complication of pregnancy with poor maternal and fetal outcomes if not managed promptly. The major foetal complication was intrauterine foetal death, while the main maternal complications were postpartum haemorrhage and anaemia, often requiring blood transfusion. Therefore, providing adequate antenatal care, early diagnosis, and timely access to emergency obstetric services can help reduce both maternal and foetal complications, prevent mortality, and decrease morbidity. Early referral to tertiary care centres, availability of blood and blood products, and prompt interventions can significantly limit adverse maternal and perinatal outcomes.
International Journal of Clinical Obstetrics and Gynaecology
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Research Journals