Title: Abruptio Placenta – A Study in Tertiary Care Centre
Authors: Dr K. Abirami M.S. OG, Dr A. Narmadhapriya MS OG PG
DOI: https://dx.doi.org/10.18535/jmscr/v8i1.132
Abstract
Introduction: Separation of the normally situated placenta either partially or totally from its implantation site before delivery is described as abruptio placentae. It is one of important cause for antepartum haemorrhage. The phenomenon of impaired trophoblastic invasion with subsequent atherosis is related in some cases of preeclampsia and abruption. Inflammation or infection may be contributory. Inflammation to be more common in prematurely separated placentas.
Aim: The aim of the study is to find the incidence of abruption in a tertiary care centre, its risk factors and to monitor maternal and fetal outcome
Material & Method: This is prospective observational study. The study was conducted at Madurai Rajaji hospital, over 3 months from June to august .total number of deliveries for 3 months being 3870 , of which we had 25 cases of abruption. All the women who were admitted with bleeding pv and preterm labour was taken as the study population.
Result: The incidence of abruption was 0.6 % which is statistically significant and is similar to other studies. The incidence is 36% among the age group 20 to 25. The incidence 40% more among multigravida. 60 % mothers presented with pain abdomen and abnormal FHR at the time of admission. Almost 64%of the mothers had Non severe preeclampsia which was the important risk factor associated with abruption the other risk factor were anemia, multiple pregnancy, preterm labour and prevlscs. Concealed abruption was seen in 68% of the cases. 90% of the mother were delivered by emergency caesarean section. 60% of the mother required blood transfusion. Fetal mortality was seen in 68% of cases. Maternal morbidity was more. DIC was the most common complication. 3 patients went in for acute renal failure requiring dialysis. 2 pts developed pulmonary edema. Maternal mortality with abruption was Nil at our centre.
Conclusion: Abrutio placenta is one of the obstetric emergency which results in maternal morbidity and fetal mortality. A timely referral, early identification of risk factors, early diagnosis, can improve the maternal outcome and fetal outcome.
Keywords: Abruption, non severe pre eclampsia, blood transfusion.
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