Study of clinical profile of abruptio placenta in tertiary care center: A retrospective observational study

Abstract

Introduction: Abruptio placenta refers to the partial or complete detachment of a normally placed placenta after foetal viability but before birth. Prevalence ranges between 0.5 % to 1 % of pregnancies. Some of the risk factors for abruptio placenta include smoking, blunt abdominal trauma, retroplacental leiomyoma, premature rupture of membranes, thrombophilic disorders, uterine anomalies, multiple pregnancies, teenage pregnancy, elderly gravida (above thirty-five), and having previous history of abruptio placenta, grades of abruptio placenta, the condition  of the foetus and Bishop's score are used to determine the kind of delivery⁷. The aim of the expectant management is to help fetus get mature enough to survive. Purpose of our study is to determine the incidence rate, risk factor, and outcome for both the mother and the foetus in cases with abruptio placenta

Materials and Methods: 36 women (28 or more weeks of gestation) diagnosed as abruptio placentae based on routine clinical examination and ultrasound were enrolled. Demographic, menstrual , obstetric & antenatal risk factor, preterm fetal outcome,  data of mother’s age, parity, gestational age, booking status, antenatal risk factors & pregnancy outcome obtained retrospectively from patient files &  computer records.

Observations and Results: Mean age of women was 26.63 ± 4.87 and maximum i.e., 16 (44 %) were between 25 to 29 years. Primi were 12 (33 %) & multi were 24 (67 %). Maximum women i.e., 16 (44 %) had gestational age between 28 to 33.6 weeks. 28 (78 %) pregnancies were booked. Majority i.e. 35 (97 %) underwent  LSCS. Amongst antenatal risk factor, Hypertensive Disorders in Pregnancy were present in majority cases i.e., 15 (42 %), Anemia was found in 22 (61 %) cases. Statistically no risk factor was found to be a contributing factor for favorable or unfavorable outcome. PPH was found in 4 (11 %), DIC in 1 (3 %) and AKI in 2 (6 %). 9 (25 %) cases had ICU admission, 19 (53 %) required blood transfusion. NICU admissions were 17 (47 %). Preterm were 25 (69 %) & term were 11 (31 %).

Conclusion: Regular antenatal checkup, early diagnosis, identification and prevention of risk factor and prompt treatment  will help us in improving maternofetal outcome.

Keywords: Abruptio placenta, maternofetal outcome, Regular antenatal checkup