DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20163873

Study of antepartum haemorrhage and its maternal and perinatal outcome

Priyanka Tyagi, Nidhi Yadav, Parul Sinha, Uma Gupta

Abstract


Background: Antepartum haemorrhage (APH) is defined as bleeding from or into the genital tract after the period of viability until delivery of fetus. Etiology includes placenta previa, abruptio placentae, local causes, systemic causes and idiopathic origin. Objective of this study was to identify factors associated with APH, and to quantitate maternal morbidity, mortality and perinatal outcome in patients with APH at a tertiary care center in India.

Methods: The study was a retrospective observational study and patient information was obtained from delivery records of 100 women presenting at gestational age of 28 weeks and above with APH. All patients with bleeding per vagina after 28 weeks of gestation were included in the study and were grouped as – Placenta Previa (PP), Abruptio Placenta (AP) or unknown causes.

Results: Out of total 100 cases of APH, placenta previa contributed to 80%, abruptio placenta 19% and 1% unknown causes. Overall maternal mortality was 6%. Perinatal mortality was 42%. Prevalence of low birth weight and preterm babies was high.

Conclusions: APH is a major cause of maternal and perinatal morbidity and mortality which could be prevented by early registration, regular antenatal care, early detection of high risk cases, and early referral to higher center. Good facilities for caesarean section, availability of blood banks and multidisciplinary approach with a good NICU can improve maternal and perinatal outcome of APH. The results of this study were found in good agreement with previous studies.


Keywords


Antepartum hemorrhage, Abruptio placenta, APH, Placenta previa

Full Text:

PDF

References


Mishra R. Ian Donald’s Practical Obstetric Problems. Seventh edition. LWW. 2014. pp. 315-328.

Bhide A, Thilaganathan B. Recent advances in the management of placenta previa. Curr Opin Obstet Gynecol. 2004;16(6):447-51.

Faiz AS, Ananth CV. Etiology and risk factors for placenta previa: an overview and meta-analysis of observational studies. J Matern-Fetal Neonatal Med Off J Eur Assoc Perinat Med Fed Asia Ocean Perinat Soc Int Soc Perinat Obstet. 2003;13(3):175-90.

Lavery JP. Placenta previa. Clin Obstet Gynecol. 1990;33(3):414-21.

Nasreen F. Incidence, Causes and outcome of placenta previa. J Postgrad Med Inst Peshawar - Pak. 2011.

Sheiner E, Shoham-Vardi I, Hallak M, Hershkowitz R, Katz M, Mazor M. Placenta previa: obstetric risk factors and pregnancy outcome. J Matern Fetal Med. 2001;10(6):414-9.

Healy DL, Breheny S, Halliday J, Jaques A, Rushford D, Garrett C, et al. Prevalence and risk factors for obstetric haemorrhage in 6730 singleton births after assisted reproductive technology in Victoria Australia. Hum Reprod Oxf Engl. 2010;25(1):265-74.

Rasmussen S, Albrechtsen S, Dalaker K. Obstetric history and the risk of placenta previa. Acta Obstet Gynecol Scand. 2000;79(6):502-7.

Antepartum Haemorrhage (Green-top Guideline No. 63). Royal College of Obstetricians and amp; Gynaecologists. Available from: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg63/.

Maurya A, Arya S. Study of Antepartum Haemorrhage and Its Maternal and Perinatal Outcome. Int J Sci Res Publ. 2014.

Pandey VP, Pandey M. Study of Antepartum Haemorrhage and its Maternal and Perinatal Outcome. 2016. Available from: http: //imsear.li.mahidol.ac.th/handle/123456789/175784.

Adekanle DA, Adeyemi AS, Fadero FF. Ante-partum haemorrhage and pregnancy outcome in Lautech teaching Hospital, southwestern Nigeria. J Med Sci. 2011:1243-7.

Arora R, Devi U, Majumdar K. Perinatal morbidity and mortality in antepartum haemorrhage. J Obstet Gynae India. 2001;51(3):102-4.

Nielsen TF, Hagberg H, Ljungblad U. Placenta previa and antepartum hemorrhage after previous cesarean section. Gynecol Obstet Invest. 1989;27(2):88-90.

Siddiqui SA, Tariq G, Soomro N, Sheikh A, Shabih-ul-Hasnain F, Memon KA. Perinatal outcome and near-miss morbidity between placenta previa versus abruptio placentae. J Coll Physicians Surg-Pak JCPSP. 2011;21(2):79-83.