Placental Abruption: An Obstetricians Nightmare – A Study of Risk Factors and Maternofoetal Outcomes at Two Tertiary Care Teaching Hospitals in South India

Abstract

Background: Abruptio placenta is a dire obstetric emergency with potentially life threatening consequences to the mother and the baby. Methods: A prospective observational study was conducted over a period of 30 months at two tertiary care medical college hospitals in Hyderabad with 274 patients with confirmed diagnosed of placental abruption. Data was collected from case sheets, questionnaires and interviewing after obtaining an informed consent. Results: The incidence of placental abruption was 1.52%. A higher incidence was noted in multiparous patients, women from lower socioeconomic status and lower BMI. Previous history of cesarean section and gestational hypertension, Polyhydramnios and PROM emerged as leading associated risk factors (25.54%, 24.8%, 14.96% and 11.31% respectively). 63.13% of patients had revealed and 36.86% had concealed haemorrhage. Anaemia was the commonest maternal complication (57.66%) followed by hypovolaemic shock (25.18%) and PPH (23.72%). Maternal mortality was 11.67%. Perinatal mortality was 60.94% with 55.1% still births and 5.84% early neonatal deaths. Conclusions: Despite advances in obstetrics, placental abruption still remains an unpredictable and unpreventable disaster. An understanding of predisposing factors and maternofoetal outcomes will help us manage these cases with a foresight.