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Category: Volume 06 Issue 08 August 2018
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Title: Observation of cases of antepartum hemorrhage in respect to fetal outcome, maternal morbidity and mortality in tertiary referral center

Authors: Archana Bharti, Poonam Singh, Neelam Nalini

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i8.134

Abstract

Introduction: Antepartum hemorrhage (APH) is defined as bleeding from or into the genital tract after 28weeks of pregnancy and before delivery of the baby. Placenta Previa and placental abruption are the major causes of APH in the third trimester of pregnancies and major contributors of maternal and fetal mortality and morbidity. To determine the incidence, relative frequency, etiopathogenesis and fetomaternal outcomes in respect to morbidity and mortality in APH in tertiary center, this study was carried out.

Material and Methods: This was one and half years study. Total 150 cases were included. Provisional diagnosis was made from detail clinical history, abdominal and vaginal examination. Ultrasonography and a gentle speculum examination was also done. Final diagnosis was made by findings at delivery and by examining the placenta after delivery. The cause of death was noted in case of maternal mortality.

Result: The incidence of APH was 1 in 57.86 pregnancies (1.72%) in present study. Placenta Previa was the commonest cause. More common in 25-30 years of age, and in multigravida. Majority of women (56.66%) had mixed type of bleeding (concealed and revealed). The total number of maternal death was 5. The main causes of death were hemorrhage, shock, renal failure and post-partum hemorrhage. Total perinatal mortality rate was 45.33% and most common cause was prematurity.

Conclusion: Good antenatal and postnatal care, adequately trained medical and paramedical staff, good referral hospital, good transport facility and institutional delivery can help in decreasing the maternal and fetal morbidity and mortality in APH.

Keywords: Antepartum hemorrhage, perinatal and maternal morbidity and mortality.

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Corresponding Author

Archana Bharti

Junior Resident, Rajendra Institute of Medical Science, Ranchi, India