Feto Maternal Outcomes in Abruptio Placenta

Introduction: Abruptio Placenta is a major cause of maternal morbidity and perinatal mortality globally and is of serious concern in the developing world. Materials and methods: A retrospective cohort study was designed and carried out between January and December 2015 in the Institute of Maternal and Child Health (IMCH) attached to GMC, Calicut. Results: We evaluated 140 cases of abruptio placenta during the study period, making its incidence 0.9%. Nearly half the cases were unbooked, with an average age of 27.5 years and nearly three-fourths of the patients were multiparae. Anemia was observed in 63 patients, with 47.8% requiring blood transfusions. Around 60% cases required emergent caesarean sections with more than 90% being managed expeditiously within 10 hours of admission. Abruptio placenta was associated with pre-eclampsia, chronic hypertension, eclampsia, HELLP syndrome, infection, post-partum haemorrhage, shock and transient renal failure. There were no maternal mortalities but abruptio placenta accounted for 30% still births. Other adverse perinatal outcomes included low APGAR, low birth weight and increased need for admission to neonatal ICU. Conclusion:Abruptio placentae continues to be responsible for increased maternal and fetal morbidity. It is neither preventable nor predictable in majority of cases.Early detection and prompt management will reduce morbidity. Joint care by obstetricians, intensivists and neonatologists is required for better maternal and fetal outcome.