Association of disorders of coagulation profile with feto-maternal outcome in abruptio placentae
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20260556Keywords:
Abruption, Coagulation disorders, Factor VIII deficiency, Factor IX deficiency, Feto-maternal outcomeAbstract
Background: Placental abruption is a significant cause of maternal morbidity and perinatal mortality. There is a paucity of literature on evaluation of coagulation profile in patients with placental abruption and their feto-maternal outcome. Therefore, the present study was designed to evaluate disorders of coagulation system and feto-maternal outcome in patients with placental abruption.
Methods: It was a prospective, observational study on 254 pregnant women diagnosed as abruption at >28 weeks gestation. Women were tested for prothrombin time, activated Partial Thromboplastin Time (aPTT), Internalised Normalised Ratio (INR), plasma fibrinogen, factor VIII, Von Willebrand Factor, factor IX, protein C, protein S and antiphospholipid antibodies. They were followed till discharge for feto-maternal outcome. Variables were compared using Unpaired t-test/Mann-Whitney Test/Chi-Square test/Fisher’s exact test.
Results: Prolonged prothrombin time was found in 251/254 (98.82%) women, factor VIII and factor IX deficiency was found in 248/254 (97.64%) and 247/254 (97.24%) women respectively. Of 254 women, 143 (56.30%) had prolonged aPTT, 134 (52.76%) had raised INR decreased serum fibrinogen was found in 111/ 254 (43.70%) women. Cases of abruption with any one coagulation defect had adverse maternal and fetal outcome. It was interesting to find that a proportion of women who had no coagulation defect were not associated with hypertensive disorders of pregnancy, delivered vaginally, and had no NICU admission or neonatal death.
Conclusions: Most of the abruption cases had factor VIII, factor IX deficiency and prolonged prothrombin time and had adverse feto-maternal outcome. However, women without any coagulation disorders had a favourable outcome.
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