A Study on risk factors and fetomaternal outcome in Abruptio placenta
Abstract
CONTEXT:
Abruptio placentae can be defined as “Separation of the placenta either partially or completely from its implantation site before delivery of the baby”.The clinical presentation varies from one patient to another. Vaginal bleeding, pain in abdomen, uterine tenderness, loss of fetal movements seem to be the classic symptoms. Placental abruption may be revealed or concealed. In the revealed type blood tracks between the membranes and the decidua escaping through the vagina. The less common concealed type occurs when blood collects behind the placenta without any external bleeding. This study is conducted to understand the rate of abruptio placenta in our study population ,its consequence on fetal and maternal outcome and to identify the associated risk factors.
AIMS & OBJECTIVE:
- To determine the risk factors and etiological factors of abruption placenta.
- To analyze the fetal and maternal outcome of abruption placenta.
MATERIAL & METHOD:
This is a prospective observational study of 50 cases of antenatal patients at Dhiraj Hospital admitted to our labour room with clinical diagnosis of abruptio placenta after 28 weeks of gestation between October 2022 and April 2024.
RESULT:
Maximum number of cases (52%) of abruption placenta in this study were between 21-25 years of age.Majority number of patients were multigravida (62%) which indicates that incidence of abruption increases with parity and a higher incidence of abruptio placenta was present in women belonging to the gestational age between 33-36 weeks.The most common presenting sign seen in this study was vaginal bleeding, followed by pain in abdomen and a tense, tender uterus. Patients who had hypertension had a maximum rate of abruption (60%) and many of them were associated with anemia. After initial resuscitation of the patient, mode of delivery was decided depending upon the state of the mother and the fetus. Commonly seen maternal complications in this study were postpartum hemorrhage, coagulation failure and hypovolemic shock. Intrauterine fetal death and neonatal mortality due to hypoxia, prematurity, IUGR were commonly seen in abruptio placenta.
DISCUSSION & CONCLUSION:
Abruptio-placenta must be included among the most dangerous obstetrical complication for both mother and fetus .Antenatal care which identifies the risk factors such as hypertension plays an important role in decreasing the incidence of abruption placenta and improving the maternal and fetal outcome.The signs and symptoms of abruptio placenta vary depending upon the severity of bleeding and the degree of separation of the placenta.Among the maternal complications,hypertension continues to be prime cause of fetal wastage with a total perinatal mortality rate between 30% and 60%. Postpartum hemorrhage (PPH) was common followed by disseminated intravascular coagulation (DIC).Routine antenatal check-up, treatment of anemia, timely referral to advanced centers and proper management with timely cesarean section, blood transfusion and good neonatal intensive care unit will further lower the perinatal and maternal morbidity and mortality.Management is directed at identifying these risk factors at an earlier stage and correcting them will do a lot of help in reducing the incidence.
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