ASSOCIATION BETWEEN PLACENTAL ABRUPTION AND CAESAREAN SECTION AMONG PATIENTS AT KHYBER TEACHING HOSPITAL PESHAWAR
Abstract
Background: Ante partum haemorrhage remains to be a major cause of morbidity and mortality.30% of this haemorrhage is attributed to placental abruption. Along with other adverse maternal outcomes, it increases the risk of Caesarean sections in patients, which is a public health concern. This study was conducted to find out whether any significant association exists between placental abruption and C-section in our set up. Methods: A cross-sectional study was conducted from July 26th, 2011 to May 1st, 2013 (i.e., 21 months) in the Department of Obstetrics and Gynaecology, Khyber Teaching Hospital Peshawar on a sample of 334 patients who presented with antepartum haemorrhage after 28 weeks of gestation. All those patients with and without placental abruption were followed throughout pregnancy and labour to detect the risk of caesarean section. Results: Among study participants, parity had the highest dispersion while gestational age had the lowest. Caesarean section was performed on 26.3% (95% CI) of the study participants. Proportion of placental abruption among patients presenting with ante partum haemorrhage was 20.6%, (95% CI) out of which 7.5% underwent C-section. Association between placental abruption and C-section was found significant at α=0.05 (p=0.03). Conclusion: Risk of caesarean section is increased in pregnancies complicated by placental abruption as compared to pregnancies complicated by other causes of ante partum haemorrhage.References
Sheikh F, Khokhar SA, Sirichand P, Shaikh RB. A study of antepartum haemorrhage: Maternal and Perinatal outcomes. Med Channel 2010;16(2):268–71.
Calleja-Agius J, Custo R, Brincat MP, Calleja N. Placental abruption and placenta praevia. Eur Clin Obstet Gynaecol 2006;2(3):121–7.
Sholl J. Abruptio placentae: Clinical management in non-acute cases. Am J Obstet Gynecol 1987;156(1):40–51.
Abbasi RM, Rizwan N, Mumtaz F, Farooq S. Feto Maternal Outcome Among Abruptio Placentae Cases at a University Hospital of Sindh. JLUMHS 2008;(2)106–9.
Kramer MS. Etiological determinants of abruption placenta. Turnbull’s text book of obstetrics. 3rd Ed. 1997;220–1.
Oyelese, Yinka MD, Ananth, Cande V. Placental Abruption. Obstet Gynecol 2006;108(4):1005–16.
Scearce J, Uzelac PS. Third-trimester vaginal bleeding. Current Diagnosis and Treatment Obstetrics and Gynecology, 10th ed. New York: McGraw-Hill. 2007:328–41.
Larsson C, Källen K, Andolf E. Caesarean section and risk of pelvic organ prolapse: a nested case-control study. Am J Obstet Gynecol 2009;200(3):243.e1–4.
Hemminki E. Impact of caesarean section on future pregnancy–a review of cohort studies. Paediatr Perinat Epidemiol 1996;10(4):366–79.
Hemminki E, Merilainen J. Long-term effects of caesarean sections: ectopic pregnancies and placental problems. Am J Obstet Gynecol 1996;174(5):1569–74.
Souza JP, Cecatti JG, Faundes A, Morais SS, Villar J, Carolli G, et al. Maternal near miss and maternal death in the World Health Organization's 2005 global survey on maternal and perinatal health. Bull World Health Organ 2010;88(2):113–9.
Azmat SK, Ali M, Ishaque M, Mustafa G, Hameed W, Khan OF, et al. Assessing predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan: results of a cross-sectional baseline survey. Reprod Health 2015;12(1):25.
Matthews TG, Crowley P, Chong A, McKenna P, McGarvey C, Regan MO. Rising caesarean section rates: a cause for concern? BJOG Int J Obstet Gynaecol 2003;110(4):346–9.
Stivanello E, Rucci P, Lenzi J, Fantini MP. Determinants of caesarean delivery: a classification tree analysis. BMC Pregnancy Childbirth 2014;14:215.
Eleje GU, Udigwe GO, Akabuike JC, Eke AC, Eke NO, Umeobika JC. The Rate of Caesarean Section in Nnewi, Nigeria: A 10-year Review. Afrimedic J 2010;1(1):11–4.
Singhal S, Nymphaea NS, Nanda S. Maternal And Perinatal Outcome In Antepartum Haemorrhage: A Study At A Tertiary Care Referral Institute. Internet J Gynecol Obstet 2008;9(2):5580.
Oyelese Y, Ananth CV. Placental Abruption. Obstet Gynecol 2006;108(4):1005–16.
Pitaphrom A, Sukcharoen N. Pregnancy outcomes in placental abruption. J Med Assoc Thai 2006;89(10):1572–8.
Dars S, Sultana F, Akhtar N. Abruptio Placentae: Risk Factors and Maternal Outcomes at a Tertiary Care Hospital. JLUMHS 2013;12(3):198–202.
Sarwar I, Abbasi Au, Islam A. Abruptio placentae and its complications at Ayub Teaching Hospital Abbottabad. J Ayub Med Coll Abbottabad 2006;18(1):27–31.
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.