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Category: Volume 07 Issue 06 June 2019
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Title: A Clinical Study of Maternal and Perinatal Outcome of Abruptio Placentae

Authors: Sayli Wankhedkar, Meenal Sarmalkar

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.61

Abstract

Aim and Objectives: The aim of present study was to study maternal and perinatal outcome in cases of abruptio placenta and initiate early intervention to bring down maternal morbidity and to prevent maternal and perinatal mortality.

Methods: A prospective observational study was done on 110 cases of abruptio placenta presenting to the labour ward and delivered. Maternal outcome such as mode of delivery, maternal complications and Operative interference were studied. Perinatal outcome in the form of birth weight, APGAR score at 1 and 5 minute, NICU admissions and perinatal deaths were studied.

Results: Incidence of abruptio placentae was 0.97%.Majority (59.1%) of cases with abruptio placenta was multipara and 39.1% were primigravida with commonest age group being 21-25 years. The associated conditions were preeclampsia (54.5), anaemia (13.6%), trauma (11.8%), polyhydramnios (5.5) and twins (1.8) and unknown (12.7%). LSCS was performed in 62% patients. 38% had a normal vaginal delivery whereas 5.5 % had a forceps delivery. Maternal complications were DIC (24.5%), PPH (14.5%), shock (10%) and ARF (5.4%). Operative Interference was done in 13.7% cases. No maternal mortality was noted. Maximum (74.6 %) were live births and 28(25.5 %) were stillbirths. The perinatal mortality was 29.1%.

Conclusions: Early intervention is the key to reduce maternal and perinatal morbidity and mortality. Availability of adequately trained staff, ICU and NICU facilities, well equipped operation theatres, blood and blood products, infrastructure is of utmost importance for active management of a patient with abruptio. Therefore tertiary care centres are an ideal setup to manage such patients.

Keywords: Abruptio placentae, Morbidity, Mortality, APGAR score, Primigravida, Polyhydramnios.

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Corresponding Author

Dr Meenal Sarmalkar

Additional Associate Professor, Department of Obstetrics and Gynaecology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra India- 400022