Title: Peripartum Management of Placenta Previa and Abruption Placenta in Rural Perspectives: A Real Test of Obstetrician’s Clinical and Surgical Skills
Authors: Dr Vijayata Sangwan, Dr Mukesh Sangwan, Dr Sunita Siwach, Dr Pinky Lakra, Dr Shivani Khandelwal, Dr Rajiv Mahendru
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.41
Abstract
Introduction: Antepartum haemorrhage (APH) complicates 3-5% of all pregnancies. Abruption placenta and placenta previa contributes 60-70% of total causes of APH. It also predisposes a patient further for PPH and makes her condition more critical.
Aim & Objectives: to present our experience on peripartum management and handling of complications in patients of abruption placenta and placenta previa.
Material & methods: this is a retrospective study in the department of obstetrics & gynecology in a rural medical college during its first three years of establishment. The data was collected from the medical records and statistically analyzed for presentation of patients, neonatal outcome and management of peripartum complications focusing on different methods of controlling postpartum haemorrhage in both the conditions.
Results: The incidence of APH, abruption placenta and placenta previa in the present study was 3.65%, 2.54% & 1.11%. Majority of patients in the study group were 25.77±4.88yrs age and multiparous (2.8±1.64). Risk factors for placenta previa were present in 18.77% patients. Neonatal morbidity and mortality were more commonly associated with abruption placenta. The most common complication was postpartum haemorrhage secondary to uterine atony, morbidly adherent placenta and DIC. Other complications include on table cardiac arrest, long ICU stay.
Conclusion: Antepartum haemorrhage itself makes patient condition haemodynamically critical and further post partum haemorrhage narrows the window of survival for the patient. An obstetrician clinical and surgical skills plays a critical role in survival of such patients.
