An Observational Study on Maternal and Perinatal Outcome in Abruptioplacenta at a Rural Tertiary Care Center

Background: Abruptio placenta is a major cause of massive obstetric hemorrhage and significant cause of maternal and neonatal morbidity and mortality worldwide and in developing countries including India. This study aimed to determine risk factors for abruptio placenta and subsequent feto-maternal outcome at a tertiary care center (hospital). Methods: A prospective study was conducted at department of obstetrics and gynaecology, RIMS Adilabad. All patients diagnosed with abruptio placenta clinically and/or sonographically were included in the study. The maternal complications and fetal outcome were analyzed in detail. Results: In this study, 82 women were diagnosed with abruption placenta. Incidence of abruptio placenta is 1.4% at our institute. Most patients in our study are multiparous (64.6%), un booked (31.7%) and are in the age group of 20-30 years (58.5%). In our study abruption placenta was mostly associated with PIH/Hypertensive disorders of pregnancy (56.09%). H/o abruption placenta in previous pregnancy (12.19%), Idiopathic (23.17%), Trauma (2.4%), PROM (2.4%) are other risk factors associated with abruptio placenta. Anemia is associated with 58% of cases. Majority (54.8%) of cases delivered vaginally, 45.12% patients were delivered by LSCS. 63.14% babies were live born, 23.17% were IUD, 13.4% were stillborn. Post partum hemorrhage (19.5%), Acute renal failure (17.7%), disseminated intravascular coagulation (15.8%) are important maternal complications. Maternal mortality rate is 2.4%. Perinatal mortality is 25.6%. Conclusion: Abruption placenta is associated with poor maternal and fetal outcome. There is need to spread awareness regarding taking adequate antenatal care so that associated risk factors could be diagnosed early and treated adequately. Prompt resuscitative measures and expedition of delivery process after abruption favours good fetomaternal outcome.