A clinical study of fetomaternal outcome in cases of abruption placentae in tribal population of North East Gujarat

Anshav D. Raval; Shivani R. Varma; Tirthraj J. Jakharia; Prachi J. Mewada

doi:10.18203/2320-1770.ijrcog20261278

Authors

Anshav D. Raval Department of Obstetrics and Gynaecology, Zydus Medical College and Hospital, Dahod, Gujarat, India
Shivani R. Varma Department of Obstetrics and Gynaecology, Zydus Medical College and Hospital, Dahod, Gujarat, India
Tirthraj J. Jakharia Department of Obstetrics and Gynaecology, Zydus Medical College and Hospital, Dahod, Gujarat, India
Prachi J. Mewada Department of Obstetrics and Gynaecology, Zydus Medical College and Hospital, Dahod, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20261278

Keywords:

Abruptio placentae, Fetal outcome, Maternal outcome, Perinatal mortality

Abstract

Background: Abruptio placentae is a serious obstetric emergency characterized by premature separation of the normally implanted placenta, leading to significant maternal and perinatal morbidity and mortality. Early identification and prompt management are essential to improve outcomes. Objectives were to evaluate the fetomaternal outcomes in patients with abruptio placentae and to analyze the association of demographic, clinical, and hematological factors with the severity of abruption and neonatal outcomes.

Methods: This hospital-based observational study included 75 patients with clinically and/or ultrasonographically diagnosed abruptio placentae admitted to a tertiary care center. Maternal demographic characteristics, antenatal risk factors, clinical presentation, hematological parameters, and obstetric outcomes were analyzed. The degree of abruption was categorized into grades, and its association with maternal findings, hemoglobin levels, clinical signs, and neonatal outcomes such as birth weight, APGAR score, and fetal survival was assessed.

Results: Most patients were in the 18-25-year age group (48%), and the majority presented in the preterm period (83.99%). Hypertensive disorders and anemia were the most common risk factors. Grade 1 abruption was seen in 50.67% of cases, followed by grade 2 (32%) and grade 3 (17.33%). Severe anemia, pallor, and edema were significantly associated with higher grades of abruption. Low birth weight (<2000 g) was observed in 76% of neonates, and 53.33% had APGAR scores ≤6. Live births accounted for 57.33% of cases, while fetal loss occurred in 42.67%.

Conclusions: Abruptio placentae is associated with high maternal and perinatal risk, particularly in preterm pregnancies with hypertensive disorders and anemia. Early antenatal risk identification, timely referral, and prompt multidisciplinary management are crucial to improve fetomaternal outcomes.

References

Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Williams Obstetrics. 26th ed. New York: McGraw-Hill Education. 2022.

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

Oyelese Y, Ananth CV. Placental abruption. Obstet Gynecol. 2006;108(4):1005-16.

Pariente G, Wiznitzer A, Sergienko R, Mazor M, Holcberg G, Sheiner E. Placental abruption: critical analysis of risk factors and perinatal outcomes. J Matern Fetal Neonatal Med. 2011;24(5):698-702.

Ananth CV, Lavery JA, Vintzileos AM, Skupski DW, Varner M, Saade G. Severe placental abruption: clinical definition and associations with maternal complications. Am J Obstet Gynecol. 2016;214(2): 272.e1-272.

Glantz C, Purnell L. Clinical utility of sonography in the diagnosis and treatment of placental abruption. J Ultrasound Med. 2002;21(8):837-40.

Matsuda Y, Kouno S, Fujita Y, Maeda Y. Risk factors for placental abruption and its clinical significance. J Obstet Gynaecol Res. 2013;39(1):22-8.

Jadhav K, Kadam M, Lokhande V, Rawte S. Study of Maternal and Foetal Outcome in Abruptio Placentae. Int J Med Sci Clin Invent. 2021;8(01):5208-13.

Charlotte B, Ezenwafor OO, Eleje GU. Feto-Maternal Outcome of Abruptio Placentae in a Tertiary Hospital in Nnewi, Nigeria. Int J Obst Gyn. 2023;3(1):1-5.

Macheku GS, Philemon RN, Oneko O, Mlay PS, Masenga G, Obure J, et al. Frequency, risk factors and feto-maternal outcomes of abruptio placentae in Northern Tanzania: a registry-based retrospective cohort study. BMC Pregn Childbir. 2015;15(1):242.

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. Europ J Obstet Gynecol Reproduct Biol. 2014;179:100-4.

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 Natural Sci Biol Med. 2014;5(2):425.

Singhal A, Yadav GS, Vyas S, Singhal M. A Study of Fetomaternal Outcome IN Abruptio Placentae. Eur J Molecular Clin Med. 2022;9(9):629-39.