ABRUPTIO PLACENTAE AND ITS COMPLICATIONS AT AYUB TEACHING HOSPITAL ABBOTTABAD
AbstractBackground: Abruptio placentae remains a major cause of perinatal morbidity and mortalityglobally, though of most serious concern in the developing world. As most known causes of abruptioplacentae are either preventable or treatable, an increased frequency of the condition remains a sourceof medical concern. Methods: The present study was undertaken at the Department of Obstetrics andGynaecology, Unit B, of the Ayub Teaching Hospital, Abbottabad, Pakistan, from July 2003 to June2004. Patients of abruptio placentae were selected from all cases of 28 weeks or greater gestation,presenting with ante partum haemorrhage during the study period. Patients underwent a completeobstetrical clinical workup including history, general physical examination, abdominal and pelvicexamination. Relevant investigations such as laboratory tests and imaging were performed. Patientswere managed according to maternal and fetal condition. Any maternal and/or fetal complicationswere noted and recorded. All data were collected on predesigned proformas and analyzed bycomputer. Results: A total of 53 cases of abruptio placentae were recorded out of 1194 cases (4.4%)admitted for delivery during the study period, giving a rate of 44 cases of abruptio placentae per 1000deliveries. Induction of labour was required in 27 (50.9%) cases, while caesarean section wasperformed in 16 (30.2%) cases. Major complications were intra uterine fetal demise (31/53, 58.5%),fetal distress (8/22 live births, 36.4%) and post partum haemorrhage, which occurred in 10 (18.9%)cases. Conclusions: A higher than expected frequency of abruptio placentae exists in our setting andthe consequences of abruptio placentae for neonatal mortality outcome are alarmingly high. Themajority of patients presented with intra uterine death so that any management protocol directed atabruptio placentae or its consequences is of little help in preventing perinatal mortality.Key Words: Abruptio placentae, ante partum haemorrhage, perinatal mortality.
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