Observational study of abruptio placenta - Fetomaternal outcomes at tertiary hospital

• Author Details:   
• Vrushali Salunke
• Anand Karale
• Hemraj Narkhede
• Vipulachandra Y ^*

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Objectives: To know the fetal and maternal outcomes in cases of placental abruption.

Materials and Methods: A cross-sectional study conducted over a period of 18 months for all the patients who were diagnosed with placental abruption. Abruption was graded as per Geoffrey Sher's classification (1978) which is retrospective grading. All data were retrieved and entered in structured format. The statistical analysis was performed and data were presented as the frequency with proportion (%) for categorical data.

Results: Out of 12599 deliveries during the study period, there were 78 cases of placental abruption with incidence of 0.61%. The age of study group varied from 19 years to 41 years, with a mean age of 27 years. Out of 78 cases, 28 (35.89%) were primigravida and 50(64.11%) were multigravidas. The time of presentation of abruption varied from 20 weeks to 40 weeks. 6(7.69%) cases were under 27 weeks, 26(33.33%) cases were of gestational age 28-32 weeks, 25 (32.05%) cases were diagnosed with abruption at 33-36 weeks and rest 21 (26.92%) cases presented after 36 weeks of gestation. Retrospective categorization according to Geoffrey Sher's Classification, 31(39.74%) cases were classified as grade 1 of placental abruption, 22(28.20%) cases were under Grade 2 and 25(32.05%) cases were of Grade 3. Among the 8 cases delivered vaginally, 3 were live births and 5 were fresh still births. 51 live births and 20 fresh still births were noted in the cases where delivery was by caesarean section. The P value calculated by Chi-Square is 0.0478, we can state that caesarean deliveries have a better live birth rate compared to vaginal delivery.

Conclusion: Placental abruption is still one among the most serious obstetric emergencies. It often presents without warning and the etiology remains obscure in many cases. Providing optimum obstetric care and timely blood and blood products transfusion services significantly decreases maternal mortalities due to placental abruption. Timely sterilization which avoids high parity, proper antenatal care, improving socio-economic status, anticipation among high-risk cases for abruption, timely diagnosis and prompt treatment of all preeclampsia cases with strict surveillance and prompt action at the time of presentation could bring better results while dealing with this morbid condition.

Keywords: Placental abruption, Retrospective, Caesarean deliveries.