Background: Abruptio placenta is a major obstetric complication and has a substantial maternal and fetal morbidity and mortality. In this retrospective cohort study, the incidence, risk factors and feto-maternal outcome assessments were ascertained of abruptio placenta in a tertiary care hospital.
Methods: A retrospective cohort study was carried out between January 01, 2019 and December 31, 2024 in St. Stephen’s hospital, Delhi. The sample comprised all pregnant females admitted with suspicion of placental abruption at 28 weeks gestation and above. Demographics, obstetric history, co-morbidities, clinical presentation, and pregnancy outcomes were examined.
Results: Incidence of abruptio placentae was 1.28% (70/5450). The risk factors of abruptio placentae were: preeclampsia / eclampsia [OR 5.26; 95% CI 3.08-8.98], diabetes [OR 2.95; 95% CI 1.53-5.70], previous caesarean section [OR 1.28; 95% CI 0.74-2.20], premature rupture of the membrane [OR 2.74; 95% CI 1.41-5.34], multigravida [OR 2.20; 95% CI 1.23-3.90], and multiparity [OR 3.25; 95% CI 1.80-5.85]. Maternal complications of abruptio placentae were antepartum haemorrhage [OR 8.66; 95% CI 4.49-16.7], postpartum haemorrhage [OR 7.62; 95% CI 3.68-15.8], Caesarean section [OR 2.76; 95% CI 1.60-4.76], need for blood transfusion [OR 13.7; 95% CI 8.3-22.7], disseminated intravascular coagulation [OR 8.5; 95% CI 6.3-15.2], longer hospital stay [OR 4.24; 95% CI 2.42-7.43]. The adverse fetal outcomes in cases of abruptio placenta were birth weight < 2.5 kg [OR 3.41; 95% CI 2.13-5.44], preterm birth [OR 2.87; 95% CI 1.71-4.82], need for NICU admission [OR 2.98; 95% CI 1.72-5.18], APGAR score at 5 minutes <7 [OR 2.04; 95% CI 1.08-3.85] and perinatal mortality [OR 2.41; 95% CI 1.08-5.36] all indicating statistical significance.
Conclusions: Abruptio placenta persists as an important contributor to maternal and perinatal morbidity and mortality. Herein, we highlight that early diagnosis and timely intervention play a crucial role in ensuring early interventions that save lives for pregnant women. If modifiable risk factors such as diabetes, hypertension and premature rupture of membranes can be treated or addressed, this may contribute to lowering the risk of abruptio placenta. Better prenatal care with improved healthcare facilities and health provider awareness is important to improve outcomes for mothers and babies affected by this condition.
International Journal of Clinical Obstetrics and Gynaecology
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