Title: Abruptio Placentae – Risk Factors and Clinical Manifestations
Authors: Lakshmi.B.S, Shilpa Nair
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.82
Abstract
Background: Abruptio placentae is one of the major cause of ante partum haemorrhage. Many risk factors are known to be associated with increased risk of abruption such as smoking, maternal age and pregnancy induced hypertension.
Objectives: To determine the risk factors of abruption in our population and to identify the signs and symptoms of abruption in them.
Materials and Methods: Retrospective case- control study where all cases of abruption which occurred in a one year period were included . Patients with classical signs and symptoms of abruption and diagnosed in the antenatal period and all patients diagnosed post natally by the presence of retroplacental clot was included in the study. Control group consisted of equal number of patients selected randomly. Statistical analysis for comparing the risk factors was performed using Chi Square test.
Result: The incidence of placental abruption during the study period was 0.52 %. Major risk factors for abruption were age more than 30 years, previous history of abruption, prematurity, pregnancy induced hypertension and Premature rupture of membrane. Most of the cases presented as abdominal pain (74.44%) and bleeding per vaginum (73.33%).
Conclusion: Placental abruption is a major cause of antepartum haemorrhage and is an obstetric emergency. Early diagnosis and prompt treatment will minimize the serious sequelae to a great extent.
Keywords: Placental abruption, Pre – eclampsia, risk factors.
References
1. SakornbutE ,Leeman L , Fontaine P. Late pregnancy bleeding. Am Fam Physician. 2007; 1199-206.
2. AnanthCV, Getahun D, Peltier MR, Smulian JC. Placental abruption in term and preterm gestations: Evidence for heterogenesity in clinical pathways . ObstetGynecol . 2006;107 : 785–92.
3. Ananth CV, Wilcox AJ , Savitz DA , et al. Effect of maternal age and parity on the risk of uteroplacental bleeding disorders in pregnancy. ObstetGynecol 1996;88:511-516.
4. Lindqvist PG, Happach C. Risk and risk estimation of placental abruption. Eur J Obstet Gynecol Reprod Biol. 2006; 126:160-4.
5. Tikkanen M. Etiology, clinical manifest-ations and prediction of placental abrup-tion. Acta Obstet Gynecol Scand .2010;89:732-40.
6. AbbasiRM ,Rizwan N, Mumtaz F, Farooq S. Maternal ouecome among abruptiopl-acentae cases at a University Hospital of Sindh . JLUMHS. 2008;7:106-9.
7. Mc Donald SD , Vermeulen MJ , Ray JG . Risk of fetal death associated with maternal drug dependence and placental abruption : A population based study . J ObstetGynecolCan . 2007;29:556-9.
8. Sanchez SE, Pacora PN, Farfan JH, Fernandez A, Qiu C , Ananth CV, et al . Risk factors of abruption placenta among Peruvian women. Am J ObstetGynecol . 2006;194:225-30.
9. Prochazka M, Lubusky M , Slavik L, Hrachovec P, Zielina P , Kudela M , et al . Selected pregnancy variables in women with placental abrupyion. Biomed Pap Med FacUnivPalacky Olomouc Czech Repub . 2006;150:271-3.
10. Matsaseng T, Bagratee JS , Moodley J . Pregnancy outcome in patients with previous history of abruption placentae .Int J GynaecolObstet . 2006;92:253-4.
11. Pitaphrom A, Sukcharoen N . Pregnancy outcomes in placental abruption. J Med Assoc Thai . 2006;89:1572-8.
12. Kramer MS, Usher RH , Pollack R , Boyd M , Usher S . Etiologic determinants of abruption placentae. Obstet Gynecol. 1997;89:221-226.
13. Krauss T ,Rath W , KuhnW . Maternal and fetal morbidity and mortality in premature abruption placentae – a retrospective analysis. Geburtshilfe Frauenheilkd. 1993;53:194-197.