Retrospective Study of Fetomaternal outcome in Antepartum haemorrhage in Caesarean Section in Tertiary hospital.

Abstract

Introduction: Antepartum haemorrhage (APH) is a grave obstetrical emergency and a leading cause of maternal and perinatal morbidity and mortality. The aim of this study was to assess risk factors as well as maternal and perinatal outcome in APH patients with LSCS.

 Methods: This retrospective observational study was conducted in 200 patients who presented with APH at 28 weeks gestation and beyond and underwent LSCS in the department of Obstetrics and Gynaecology at tertiary care hospital from January 1, 2015, to December 31, 2020

Results: Majority of the patients (38%) were in the age group of 26-30 years. 97.5% cases were registered. 64% were multigravida presented at gestational age between 33.1-37 weeks. (81, 40.5%) with vaginal bleeding (94, 47%). The most common risk factors observed were multiparity (64%), previous LSCS (13%), hypertensive disorders (35%), trauma, malpresentation, anaemia. Postpartum haemorrhage (19.5%) was most common complication followed by disseminated intravascular coagulation (11.5%), acute renal failure (4%), puerperal sepsis (3.5%). There were overall 4 (2%) maternal deaths. 26 (13%) patients required admission in ICU. Prematurity (28.5%), asphyxia (4.5%) and jaundice (8%) were the perinatal complications observed. The incidence of stillbirth was higher in patients with abruptio placenta compared to patients with placenta previa [Chi-Square test (p<0.05)].

Conclusion: Awareness regarding risks and consequences should be made amongst patients with APH along with their family members. They should be considered as high risk and timely management should be offered in tertiary care hospital.

Keywords: Antepartum Haemorrhage, Abruptio placenta, Placenta previa.