Prospective follow up study of maternal and foetal outcome in abruption placenta

Poovathi M., Raji .


Background: Abruptio placentae (AP) which is a major cause of maternal morbidity, mortality and perinatal mortality.  Abruptio placentae are one of the leading causes of perinatal deaths. Abruptio placentae increase the neonatal morbidity and mortality. It is one of the recognized causes of low birth weight. The purpose of this study was to examine the risk factors for abruptio placentae together with the maternal and fetal outcome in a tertiary care government medical college hospital.

Methods: All cases of abruptio placentae admitted in the Department of Obstetrics, Government Raja Mirasdar Teaching Hospital, attached to Government Thanjavur Medical College, Tamilnadu, India during the period August 2014 to July 2015 for the period of one year were included in the study. All infants born to those cases were analyzed as live birth or stillbirth.  Apgar score and weight of live born infants were also analyzed. Maternal complications such as DIVC, Renal failure, PPH were also analyzed.

Results: The total number of abruptio placentae collected during this period was 102, while the total number of births during the same period was 14620 giving and incidence of 102/14620 (0.69% or 6.9 per thousand live births) for abruptio placentae. The combined stillbirths and first month deaths were 20.2%. Abruptio placentae were associated with pre-eclampsia, diabetes, polyhydramnios and hypertension. Parity and maternal age were not associated with an increased incidence of abruption placentae.

Conclusions: We found an increased risk for abruptio placentae associated with maternal diabetes, hypertension, pre-eclampsia and polyhydramnios. Abruptio placentae were associated with adverse maternal and foetal outcomes.


Frequency, Abruptio placentae, Risk factors, Feto-maternal outcomes

Full Text:



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

Ananth CV, Getahun D, Peltier MR, Smulian JC. Placental abruption in term and preterm gestations: evidence for heterogeneity in clinical pathways. Obstet Gynecol. 2006;107(4):785-92.

Ananth CV, Wilcox AJ. Placental abruption and perinatal mortality in the United States. AJE. 2001;153(4):332-7.

Ananth CV, Cnattingius S. Influence of maternal smoking on placental abruption in successive pregnancies: a population-based prospective cohort study in Sweden. AJE. 2007;166(3):289-95.

Rasmussen S, Irgens L, Dalaker K. The effect on the likelihood of further pregnancy of placental abruption and the rate of its recurrence. Br J Obstet Gynaecol. 1997;104(11):1292-5.

Bibi S, Ghaffar S, Pir MA, Yousfan S. Risk factors and clinical outcome of placental abruption: a retrospective analysis. JPMA. 2009;59(10):672-4.

Carr SR. High risk pregnancy: management options. JAMA. 1995;273(3):259-60.

Hall DR. Abruptio placentae and disseminated intravascular coagulopathy. Semin Perinatol. 2009;33(3):189-95.

Jabeen M, Gul F. Abruptio placentae: risk factors and perinatal outcome. J Postgrade Med Inst. 2011;18(4):669-76.

Sarwar I, Abbas A, Islam A. Abruptio placentae and its complication at Ayub Teaching Hospital Abbotabad. J Ayub Med Coll Abbottabad. 2006;18(1):27–31.

Jakobsson M, Gissler M, Paavonen J, Tapper AM. The incidence of preterm deliveries decreases in Finland. BJOG. 2008;115(1):38-43.

Morgan K, Arulkumaran S. Antepartum haemorrhage. Curr Obstet Gynaecol. 2003;13(2):81-7.

Salihu HM, Bekan B, Aliyu MH, Rouse DJ, Kirby RS, Alexander GR. Perinatal mortality associated with abruptio placenta in singletons and multiples. Am J Obstet Gynecol. 2005;193(1):198-203.

Nath CA, Ananth CV, Smulian JC, Shen-Schwarz S, Kaminsky L. Histologic evidence of inflammation and risk of placental abruption. Am J Obstet Gynecol. 2007;197(3):319.e311-9.

Kyrklund-Blomberg NB, Gennser G, Cnattingius S. Placental abruption and perinatal death. Paediatr Perinat Epidemiol. 2001;15(3):290-7.

Rasmussen S. Abruptio placentae – relationship with other placental dysfunction related conditions. Norsk Epidemiologi. 2007;17(2):191-7.

Sanchez SE, Williams MA, Pacora PN, Ananth CV, Qiu C, Aurora SK, Sorensen TK. Risk of placental abruption in relation to migraines and headaches. BMC Womens Health. 2010;10:30.

Getahun G, Oyelese Y, Salihu HM, Ananth CV. Previous Cesarean delivery and risks of placenta previa and placental abruption. Obstet Gynecol. 2006;107(4):771-8.

Rasmussen S, Irgens LM, Dalaker K. A history of placental dysfunction and risk of placental abruption. Paediatr Perinat Epidemiol. 1999;13(1):9-21.

Lydon-Rochelle M, Holt VL, Easterling TR, Martin DP. First-birth cesarean and placental abruption or previa at second birth. Obstet Gynecol. 2001;97(5):765-9.

Sanchez SE, Pacora PN, Farfan JH, Fernandez A, Qiu C, Ananth CV, Williams MA. Risk factors of abruptio placentae among Peruvian women. Am J Obstet Gynecol. 2006;194(1):225-30.

Wandabwa J, Doyle P, Kiondo P, Margaret A, Wandabwa A, Aziga F. Risk factors for severe abruptio placenta in Mulago Hospital, Kampala, Uganda. Afr Health Sc. 2005;5(4):285-90.

Sheiner E, Shoham-Vardi I, Hallak M, Hadar A, Gortzak-Uzan L, Katz M, Mazor M. Placental abruption in term pregnancies: clinical significance and obstetric risk factors. J Matern Fetal Neonatal Med. 2003;13(1):45-9.

Ananth CV, Wilcox AJ, Savitz DA, Bowez WA, Jr, Luther ER. Effects of maternal age and parity on the risk of uteroplacental bleeding disorders of pregnancy. Obstet Gynecol. 1996;88:511-6.

Williams MA, Lieberman E, Mittendorf R, Monson RR, Schoenbaum SC. Risk factors for abruptio placentae. Am J Epidemiol. 1991;134:965-72.

Kramer MS, Usher RH, Polllack R, Boyd M, Usher S. Etiologic determinants of abruptio placentae. Obstet Gynecol. 1997;89:221-6.

Hung TH, Hsieh CC, Hsu JJ, Lo LM, Chiu TH, Hsieh TT. Risk factors for placental abruption in an Asian population. Reprod Sci J. 2007;14(1):59-65.

Tikkanen M, Nuutila M, Hiilesmaa V, Paavonen J, Ylikorkala O. Prepregnancy risk factors for placental abruption. Acta Obstet Gynecol Scand. 2006;85(1):40-4.

Tikkanen M, Nuutila M, Hiilesmaa V, Paavonen J, Ylikorkala O. Clinical presentation and risk factors of placental abruption. Acta Obstet Gynecol Scand. 2006;85(6):700-5.

Rageth JC, Juzi C, Grossenbacher H. Delivery after previous cesarean: a risk evaluation. Swiss Working Group of Obstetric and Gynecologic Institutions. Obstet Gynecol. 1999;93(3):332-7.

Nayama M, Tamakloé-Azamesu D, Garba M, Idi N, Djibril B, Kamayé M. Abruptio placentae. Management in a reference Nigerien maternity. Prospective study about 118 cases during one year. Gynecol Obstet Fertil. 2007;35(10):975-81.

Cunningham GF, MacDonald PC, Gant NF, et al. Williams obstetrics. 19. Norwalk: Appleton & Lange; 1993. eds, chapter 37. Obstetric hemorrhage; pp. 819-851.

Rasmussen S, Irgens LM, Albrechtsen S, Dalaker K. Women with a history of placental abruption: when in subsequent pregnancy should special surveillance for a recurrent placental abruption be initiate? Acta Obstet Gynecol Scand. 2001;80(8):708-12.

Abu-Heija A, Al-Chalabi H, El-lloubani N. Abruptio placentae: risk factors and perinatal outcome. J Obstet Gynaecol Res. 1998;24(2):141-4.

Hossain NKN, Sultana SS, Khan N. Abruptio placenta and adverse pregnancy outcome. J Pak Med Assoc. 2010;60(6):443-6.

Thieba B, Lankoande J, Akotionga M, Kyelem C, Ouedraogo A, Ouedraogo CM. Abruptio placentae: epidemiological, clinical and prognostic aspects with respect to a 177 case series. Gynecol Obstet Fertil. 2003;31(5):429-33.

Ananth CV, Peedicayil A, Savitz DA. Effect of hypertensive diseases in pregnancy on birthweight, gestational duration, and small-or-gestational-age births. Epidemiology. 1995;6(4):391-5.

Saeed M, Rana T. Fetomaternal outcome in pregnancies complicated with placental abruption. PJMH. 2011;5(1):1-5.

Du Toit MM, Smith M, Odendaal HJ. The role of prenatal alcohol exposure in abruptio placentae. S Afr Med J. 2010;100(12):832-5.