Fetal and maternal outcomes among pregnant women with placental abruption associated with disseminated intravascular coagulation attending a rural tertiary care centre


  • Sudha Mallidi Department of Gynecology, Sri Devaraj URS Academy of Higher Education and Research, Bangalore, Karnataka, India
  • Munikrishna M. Department of Gynecology, Sri Devaraj URS Academy of Higher Education and Research, Bangalore, Karnataka, India




Abruption placentae, Disseminated intravascular coagulation, Postpartum hemorrhage, Perinatal mortality, Maternal mortality


Background: Placental abruption is the separation of the placenta from the uterine wall before the delivery of the fetus, and its frequency varies between 0.4 and 1%. The objective of this study was to determine risk factors and maternal and fetal complications in cases of abruptio placentae.

Methods: A record-based study was conducted in the Obstetrics and Gynaecology department at a rural tertiary care centre between January 2015 and December 2019. All 72 pregnant women admitted with suspicion of placental abruption at 28 weeks of gestation and beyond were included in the study. All data were retrieved from the maternity register, patient files. The maternal outcome was assessed by mode of delivery, need for blood transfusion, parity, and any complications. Neonatal outcome was assessed by neonatal intensive care unit admission, still and live births. Data collected was entered and analysed by using coGuide software.

Results: A total of 72 subjects were included in the final analysis. Most 58 (81%) of them were 21-30 years old. Forty-three patients (59.72%) were diagnosed to be preeclamptic. Forty-three (59.72%) of them had a vaginal delivery. Out of 72, 66 (91.67%) patients did not have any maternal complications. Most 41 (56.94%) births were stillbirths, and only 7 (9.72%) newborns required intensive care unit (ICU) admission.

Conclusions: Placental abruption is one of the major threats to the well-being of pregnant women, with an alarmingly high rate of 41 (56.94%) stillbirths.


Tikkanen M. Placental abruption: epidemiol- ogy, risk factors and consequences. Acta Obstet Gynecol Scand. 2011;90(2):140-9.

Takeda J, Takeda S. Management of disseminated intravascular coagulation associated with placental abruption and measures to improve outcomes. Obstet Gynecol Sci. 2019;62(5):299-306.

Ruiter L, Ravelli ACJ, de Graaf IM, Mol BWJ, Pajkrt E. Incidence and recurrence rate of placental abruption: a longitudinal linked national cohort study in the Netherlands. Am J Obstet Gynecol. 2015;213(4):573.

Imanaka S, Naruse K, Akasaka J, Shigemitsu A, Iwai K, Kobayashi H. Vaginal delivery after placental abruption and intrauterine fetal death, including failed cases. Int J Gynecol Obstet. 2014;126(2):180-1.

Ananth CV, Keyes KM, Hamilton A, Gissler M, Wu C, Liu S, et al. An international con- trast of rates of placental abruption: An age-period-cohort anal- ysis. PLoS One. 2015;10:e0125246.

Wang L, Matsunaga S, Mikami Y, Takai Y, Terui K, Seki H. Pre-delivery fibrinogen predicts adverse maternal or neonatal outcomes in patients with placental abruption. J Obstet Gynaecol Res. 2016;42(7):796-802.

Shinde GR, Vaswani BP, Patange RP, Laddad MM, Bhosale RB. Diagnostic performance of Ultrasonography for detection of abruption and its clinical correlation and maternal and foetal outcome. J Clin Diagnostic Res. 2016;10(8):4-7.

Oyeless YAC. Placental abruption. J Am Obs Gynaecol. 2006;108(4):1005-16.

Saquib S, Hamza LK, AlSayed A, Saeed F, Abbas M. Prevalence and Its Feto-Maternal Outcome in Placental Abruption: A Retrospective Study for 5 Years from Dubai Hospital. Dubai Med J. 2020;3(1):26-31.

Su J, Yang Y, Cao Y, Yin Z. The predictive value of pre-delivery laboratory test results for the severity of placental abruption and pregnancy outcome. Placenta. 2021;103:220-5.

Mishra R, Misra AP. Abruptio placenta and its maternal and fetal outcome. Int J Reprod Contracept Obstet Gynecol. 2019;8(8):3323.

Onishi K, Tsuda H, Fuma K, Kuribayashi M, Tezuka A, Ando T, et al. The impact of the abruption severity and the onset-to-delivery time on the maternal and neonatal outcomes of placental abruption. J Matern Neonatal Med. 2020;33(22):3775-83.

BDSS Corp. coGuide Statistics software, Version 1.03, India. BDSS corp. 2020. Available at: https://www.coguide.in. Accessed on 19 October 2021.

Kapadiya LDB. Study of Maternal and Perinatal Outcome in 100 case of Abruptio Placentae. J Med Res Heal Sci. 2017;6(7):84-8.

Ananth CV, Lavery JA, Vintzileos AM, Skupski DW, Varner M, Saade G, et al. Severe placental abruption: Clinical definition and associations with maternal complications. Am J Obstet Gynecol. 2016;214(2):272.

Atkinson AL, Santolaya-Forgas J, Blitzer DN, Santolaya JL, Matta P, Canterino J, et al. Risk factors for perinatal mortality in patients admitted to the hospital with the diagnosis of placental abruption. J Matern Neonatal Med. 2015;28(5):594-7.

Boisramé T, Sananès N, Fritz G, Boudier E, Aissi G, Favre R, et al. Placental abruption: Risk factors, management and maternal-fetal prognosis. Cohort study over 10 years. Eur J Obstet Gynecol Reprod Biol. 2014;179:100-4.

Igwegbe AO, Eleje GU, Okpala BC. Management outcomes of abruptio placentae at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. Niger J Med. 2013;22(3):234-8.

Wahane DA, Zele DM, Patil DB. A study of maternal and fetal outcome in cases of abruptio placentae. Int J Clin Obstet Gynaecol. 2020;4(4):71-4.

Li Y, Tian Y, Liu N, Chen Y, Wu F. Analysis of 62 placental abruption cases: Risk factors and clinical outcomes. Taiwan J Obstet Gynecol. 2019;58(2):223-6.






Original Research Articles