Abstract
MATERNAL AND PERINATAL OUTCOME IN CASES OF ABRUPTIO PLACENTA AT A TERTIARY CARE INSTITUTE OF WESTERN INDIA - THREE YEAR RETROSPECTIVE STUDY

*Dr. Shital U. Lad, Dr. Umesh P. Lad and Dr. Mangala A. Shinde

ABSTRACT

Background: Placental abruption occurs when there is compromise of the vascular structures supporting the placenta. There is disruption of the vascular network connecting placental vessels and the maternal side of fetoplacental unit. Abruptio placenta is one of the leading causes of maternal and perinatal mortality. The diagnosis is confirmed on the presence of retroplacental clot, which is used to estimate the amount of bleeding and severity of abruption. As per the Sample Registration System India the maternal mortality is 113/100000 live births. This study was planned to assess prevalence, associated risk factors, maternal and fetal outcome of placental abruption. Methods and materials: This is a three year retrospective study, data of patients admitted for delivery in Department of Obstetrics and Gynaecology at our institute. Total 23645 case records from 1st Jan 2017 to 31st dec 2019 were analyzed as per study protocol. Results: In our study population of 23645 Cases, there were 463 cases of abruptio placenta this gives prevalence of 1.95%. Maximum number of cases of Abruptio Placenta were in the age group of 25 to 30 years with low socioeconomic status, gravida 2-3, unbooked and gestational age more than 37 weeks. 50.53 % cases were having hypertensive disorders, 47.97 % cases had Grade 2 abruptio placenta, 79.3 % patients were delivered vaginally, 53.13% patients had postpartum hemorrhage (PPH). 67.81% patients had postpartum anemia and 63.49% required blood transfusion. Maternal mortality on our study population was 6.69%. 31.1 % neonates required NICU admission. Perinatal deaths in cases of abruptio placenta was 29.8 %. Conclusion: Abruptio placenta is one of the leading cause of maternal and perinatal mortality. PPH is common complication in cases of abruptio placenta and most of the patients required blood transfusion during their hospital stay. NICU admission is required in 31% of the neonates in the study population indicating that early neonatal care is of immense importance. Early diagnosis and timely referral to higher centers is recommended to improve the outcome in the patients complicated due to abruptio placenta.

Keywords: Abruptio placenta, maternal outcome, perinatal outcome, Post partum Hemorrhage (PPH), maternal mortality.


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