Abruptio placentae: Risk factors and maternal outcomes at a tertiary care hospital

Objective: the objective of this study was to determine risk factors and maternal complications in cases of abruptio placentae. study design: it was an observational and descriptive study. setting: this study was conducted in obstetric and gynaecology unit-i of liaquat university hospital hyderabad from november 2011 to october 2012 (12-months). methodology: all the pregnant women with gestational age 24 weeks or greater on ultra-sound having retroplacental clot on ultrasound and/or painful vaginal bleeding were included in this study by using non-probability purposive sampling technique whereas women presenting with vaginal bleeding due to causes other than abruptio placentae were excluded from the study. results: during the study period total 3329 women delivered among which 115 presented with abruptio placenta making the proportion of 3.46%. among these 115 cases only 11 (9.57%) were booked. women delivered vaginally were 74 (64.35%) whereas 41 (35.65%) underwent operative delivery. in this study the most frequent age group was >30 years (51,44.35%) with mean±sd age of 30.02±7.648 years. majority (62,53.91%) were grandmultiparous with mean±sd parity of 4.98±3.068. most of the women (76,66.09%) presented with gestational age >37-weeks. gestational age >37 weeks was most frequent risk factor followed by hypertension (59.13%),grandmultiparity (53.91%),anemia (38.26%),poverty (19.13%),smoking (12.17%) and trauma (2.61%). maternal outcomes were postpartum anemia (44.35%),shock (35.65%),pph (28.70%),prom (13.91%),postpartum infection (6.96%),dic (4.35%),renal failure (4.35%) and maternal mortality (2.61%). conclusion: abruptio placentae is still one of the major threat to the well being of pregnant women in our population with alarmingly high rate of 3.46% as compared to worldwide rate of 0.7-1%. gestational age >37-weeks,hypertension,grandmultiparity and anemia are found to be major risk factors for abruptio placentae whereas maternal age does not seem to have any association.