Frequency, maternal and fetal outcome of abruptio placenta in a rural Medical College Hospital, Mirpurkhas Sindh

摘要

Objective: To determine the frequency, maternal and fetal outcome of abruptio placentae in a rural medical college hospital, Mirpurkhas Sindh, Pakistan. Methodology: This is an observational prospective study conducted at obstetric and gynaecology department of Muhammad Medical College Hospital during one year from 1st June 2007 to 31st May 2008. All patients with diagnosis of abruptio placenta and gestational age of >24 weeks were included in the study. Data were collected on questionnaire after informed consent and results were analyzed by calculating percentages. Results: Total number of women delivered in ward during study period was 2132. Abruptio placentae was seen in 84(3.9%) patients. Majority of women n=43 (51.1%) were in the age group of 25-30 years. Incidence was higher in multi-parous, being 73 (86.9%). A total of 59(70%) women were anemic. Pregnancy induced hypertension was seen in six (7%), diabetes in five (6%) and multiple pregnancy in four (5%). No risk factor was present in 10(12%) women. As regards mode of delivery, 62(74%) women delivered spontaneously vaginally and 21(25%) underwent caesarean section. One patient died undelivered cause being severely anemic, shock and disseminated intravascular coagulation (DIC). Major maternal complication seen was hypovolumic shock in 21(25%), followed by postpartum hemorrhage in 11(13%), altered coagulation profile in six(7%) and renal failure in two (2.3%) of patients. 52(62%) women delivered alive babies while 32(38%) were stillborn. Out of 52 alive born, two died within first week of birth due to prematurity. Overall perinatal mortality was 40.4%. Conclusion: Abruptio placenta is associated with high rate of maternal and fetal morbidity and mortality and to reduce this, the risk factors associated with abruptio placenta must be evaluated before and during pregnancy