Association of abruptio placenta in patient with pre-eclampsia with severe features and without severe features

Rakshith Nagaraj; Hemalatha C. Ramakrishnappa; Anusha B. Chandrashekhar; Swathi L. Iyengar

doi:10.18203/2320-1770.ijrcog20240786

Authors

Rakshith Nagaraj Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysuru, Karnataka, India
Hemalatha C. Ramakrishnappa Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysuru, Karnataka, India
Anusha B. Chandrashekhar Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysuru, Karnataka, India
Swathi L. Iyengar Department of Obstetrics and Gynecology, Mysore Medical College and Research Institute, Mysuru, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20240786

Keywords:

Abruption, Pre-eclampsia, Severe features

Abstract

Background: Placental abruption is responsible for increased risk of maternal and fetal morbidity and mortality worldwide. Studies specific to placental abruption in pregnancy-induced hypertension (PIH) are still lacking. This study is designed to focus on collecting data on placental abruption and to objectively determine its impact on the outcome of pregnancy complicated with PIH in terms of improving fetal and maternal morbidity and mortality.

Methods: This was retrospective observational study conducted at Cheluvamba Hospital, Mysore Medical College and Research Institute (MMCRI), Mysore, in the department of obstetrics and gynaecology. All pregnant women with diagnosis of abruptio placenta over 28 weeks and with PIH between January 2022 to August 2023 were included. Data was collected from medical records department and results were analysed.

Results: During the study period there were total of 14027 deliveries. Of this 63 (0.44%) occurred in patients with placental abruption with PIH. Mean age group was 24.57 years; majority were multigravida (58.46%) Majority were preterm (77.77%). 61.90% had pre-eclampsia with severe features. Mean systolic blood pressure (SBP) was 151.90 mmHg, diastolic blood pressure (DBP) was 98.73 mmHg. 65.08% delivered by caesarean section. 47.61% was the perinatal mortality, perinatal asphyxia was 45.71%, prematurity was 65.71%, low birth weight was 84.12%. 71.42% was the neonatal intensive care unit (NICU) admission rate. Maternal complications seen was postpartum haemorrhage (PPH) (31.74%), requiring blood and blood products transfusion (63.49%), coagulopathy (14.28%), shock (12.69%). 4 women developed severe features of pre-eclampsia in postpartum period, 2 of them needed MgSO₄. 58.73% had requirement of antihypertensives in postpartum period.

Conclusions: Abruption is one of the obstetric emergencies. In our study severe adverse maternal and perinatal outcomes were more pronounced in pre-eclampsia with severe features and it needs an individual and intense surveillance and management to have better maternal and perinatal outcome.

Metrics

Metrics Loading ...

References

Bandebuche S, Sagade B, Sontakke AN. Serum magnesium in pregnancy induced hypertension. Int J Res Med Sci. 2013;1:413-6.

Karki P, Malla P, Das H, Uprety DK. Association between pregnancy-induced hypertensive fundus changes andfetaloutcomes. Nepal J Ophthalmol. 2010;2:26-30.

Goswami P, Lata H, Memon S, Khaskhelli LB. Excessive placental clacification observed in pih patients and its relation to fetal outcome. J Liaquat Uni Med Health Sci. 2012;11:143-8.

Venkateswaramurthy N, John C, Perumal P. Study on antihypertensives in preeclampsia. Asian J Pharm Clin Res. 2012;3:126-8.

Mukherjee S, Bawa AK, Sharma S, Nandanwar YS, Gadam M. Retrospective study of risk factors and maternal and fetal outcome in patients with abruptio placentae. J Nat Sci Biol Med. 2014;5(2):425-8.

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

Minire A, Mirton M, Imri V, Lauren M, Aferdita M. Maternal complications of preeclampsia. Med Arch. 2013;67:339-41.

Guimarães Filho HA, da Costa LL, Araújo Júnior E, et al. Placenta: angiogenesis and vascular assessment through three-dimensional power Doppler ultrasonography. Arch Gynecol Obstet. 2008, 277:195-200.

Yinka Oyelese CVA. Placental Abruption. Obstet Gynecol. 2006;108:1005-16.

Tikkanen M. Placental abruption: epidemiology, risk factors and consequences. Acta Obstetricia et Gynecologica Scandinavica. 2011;90:140-9.

Khan S, Chughani G, Amir F, Bano K. Frequency of Abruptio Placenta in Women With Pregnancy-Induced Hypertension. Cureus. 2022;14(1):e21524.

Pritchard JA, Cunningham FG, Pritchard SA, Mason RA. On reducing the frequency of severe abruptio placentae. Am J Obstet Gynecol. 1991;165(5):1345-51.

Memon NY, Mumtaz F, Farooq S. Incidence of Placental Abruption: Morbidity/mortality associated with it. Professional Med J. 2013;20(03):422-8.

Ananth CV, Peltier MR, Kinzler WL, Smulian JC, Vintzileos AM. Chronic hypertension and risk of placental abruption: is the association modified by ischemic placental disease? Am J Obstet Gynecol. 2007;197(3):273.

Zetterström K, Lindeberg SN, Haglund B, Hanson U. Maternal complications in women with chronic hypertension: a population-based cohort study. Acta obstetricia et gynecologica Scandinavica. 2005;84(5):419-24.

Bibi S, Ghaffar S, Pir MA, Yousfani S. Risk factors and clinical outcome of placental abruption: a retrospective analysis. Shock. 2009;22:20.

Parker SE, Werler MM, Gissler M, Tikkanen M, Ananth CV. Placental Abruption and Subsequent Risk of Pre‐eclampsia: A Population‐Based Case–Control Study. Paediatric Perinat Epidemiol. 2015;29(3):211-9.

Barua S, Chakraborty A, Samanta A, Naskar A. Evaluation of maternal and fetal outcome in patients of abruptio placentae in a tertiary care center, Kolkata: A descriptive and observational study. Asian J Med Sci. 2022;13(8).

Alka, Dudhrejia K. An observational study of feto-maternal outcome in cases of abruptio placentae. Int J Reprod Contracept Obstet Gynecol. 2017;6:3264-70.