Abstract
Background: Antepartum hemorrhage is an obstetric emergency contributing to a significant amount of perinatal & maternal morbidity and mortality. The main causes of APH are placenta previa, abruptio placentae, indeterminate cause or local causes of genital tract. APH complications can be fetal as well as maternal. The maternal complications are malpresentation, premature labor, postpartum hemorrhage, sepsis, shock and retained placenta. Various fetal complications are prematurity, low birth weight, intrauterine death, congenital malformation and birth asphyxia.
Objective: To study maternal and perinatal outcome in patients of APH at a tertiary care referral hospital in Western Rajasthan.
Material and Methods: This was a retrospective observational study conducted over a period of one year. A total of 112 cases of APH were studied. The diagnosis of all cases was made on the basis of history, clinical examination and ultrasonography. All the cases of hemorrhage were grouped as: Placenta Previa, Abruptio Placenta or other causes.
Results: Out of 8623 deliveries, 112 had APH, incidence being 1.29%. Maximum number of cases about 86(76.8%) were of placenta previa followed by abruptio placentae in 23 cases (20.5%) and the least was unclassified hemorrhage 3(2.7%). The incidence of APH was highest 43.8% in the age group 25-29 years. Anemia was the most common complication (51.7%) in APH patients. Neonatal jaundice was the most common complication (26.8%) amongst the neonate of APH.
Conclusion: High incidences of APH are associated with iron deficiency anemia and lack of awareness in India. Maternal and perinatal morbidity and mortality could be prevented by early regular antenatal care, improved nutritional status, better antenatal services, increased awareness, and timely caesarean section.
Keywords: Abruptio Placenta, Anemia, Antepartum hemorrhage, Placenta Previa.
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Corresponding Author
Mangal Chand Yadav
Dr S N Medical College, Department of Obstetrics and Gynecology, Jodhpur, Rajasthan, India