A prospective study of maternal outcome in antepartum haemorrhage in tertiary care center in northern India

Authors

  • Shaveta Jain Department of Obsterics and Gynecology, Pt. B. D Sharma, PGIMS, Rohtak, Haryana, India
  • Nitin Jain Department of Radiology, Pt. B.D Sharma, PGIMS, Rohtak. Haryana, India
  • Pushpa Dahiya Department of Obsterics and Gynecology, Pt. B. D Sharma, PGIMS, Rohtak, Haryana, India
  • Seema Rohilla Department of Radiology, Pt. B.D Sharma, PGIMS, Rohtak. Haryana, India
  • Roopa Malik Department of Obsterics and Gynecology, Pt. B. D Sharma, PGIMS, Rohtak, Haryana, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20151493

Keywords:

Antepartum hemorrhage, Maternal mortality

Abstract

Background: Antepartum hemorrhage (APH) is a grave obstetrical emergency. It is leading cause of maternal death. Aim of the present study was to see maternal outcome patient with APH.

Methods: It was a prospective study carried out over a period of one year on 100 women admitted with the diagnosis of APH at Pt. B.D Sharma medical college, Rohtak, Haryana, India, a tertiary care center. 100 patients with antenatal hemorrhage were studied prospectively. History was taken regarding age, hemoglobin status, blood unit given, ultrasound done to note type of placenta, distance of placenta from Os noted, third stage and delayed complication recorded.

Results: 40.7% patients of placenta previa had immediate LSCS. 44.4% patients of placenta previa delayed LSCS was done after expectant management. 61.76% of patients of abruptio placentae had immediate vaginal delivery. 16% had atonic postpartum haemorrhage as third stage complication. One patient lynch sutures were applied. In 2 cases bilateral internal iliac artery ligation was done. In 3 cases bilateral uterine artery ligation done to control PPH. 71% patients of APH had postpartum anemia as delayed complication.

Conclusions: The single most important factor in reducing maternal mortality has been the increase use of caesarean delivery in cases of abruptio placentae. Anemia is the most common cause of maternal morbidity (80%) associated with APH in the present study.

References

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

Cunningham FG, Gant NF, Leveno KJ, Gistrap III LC, Hauth JC, Wenstrom KD. Obstetrical hemorrhage: Williams Obstetrics. 21st ed. New York, McGraw Hill; 2001:619-669.

Hibbard BM, Jeffcoate TNA. Abruptio placentae. Obstet Gynecol. 1966;27:155-67.

Chamberlan GVP, Philipp E, Howlett B, Masters K. Br Birth Obstet Gynecol. 1970;45:160-3.

Green JR. Placenta abnormalities: Placenta previa and abruptio plcentae, Maternal fetal medicine. In: Creasy RK, Resnik R, eds. Principle and Practice. 3rd ed. Philadelphia, WB Saunders, 1989;588-602.

Crane JMG, Van Denhof MC, Dodds L, Armson A, Listen R. Neonatal outcomes with placenta previa. Obstet Gynecol. 1999;93:541-4.

Frederiksen MC, Glassenberg R, Stika CS. Placenta previa: A 22 year analysis. Am J Obstet Gynecol 1999;180:1432-6.

Ananth CV, Smulian JC, Vintziteos AM. Incidence of placental abruption in relation to cigarette smoking and hypertensive disorders during pregnancy: a meta-analysis of observational studies. Obstet Gynecol 1999;93:622-8.

Abdella TN, Sibai BM, Hays JM, Anderson GD. Relationship of hypertensive disease with abruptio placental. Obstet Gynecol. 1984;63:365-70.

Menon. Accidental haemorrhage. J Obst Gyne India. 1961;11:35-5.

Brenner WF, Edelman DA, Hendricks CH. Characteristics of patients with placenta previa and results of expectant management. Am J Obstet Gynecol. 1975;155:180-4.

William RF, William DF. Placenta previa: A critical appraisal of 8 years mangement. 1960;80:10-6.

Bhide A, Prefumo F, Maone J, Hollis B, Thilaganathan B. Placental edge to internal os distance in the late third trimester and mode of delivery in placenta previa. Br J Obstet Gynaecol. 2003;11:860-4.

Crane JMG, Vandenhof MC, Dodds L, Armson BA, Liston R. Maternal complications with placenta previa. Am J Perinatol. 2000;17:101-5.

B Lynch C, Coker A, Lawl AH, Abu I, Cowen MJ. The B-Lynch surgical technique for the control of massive postpartum hemorrhage: an alternative to hysterectomy? Five cases reported. Br J Obstet Gynaecol. 1997;104:372-5.

O’Leary JA. Uterine artery ligation in the control of post caesarean haemorrhage. Reprod Med. 1990;46:189-93.

Clark SL, Phelan JP, Yeh SY, Bruce SR, Paul RH. Hypogastric artery ligation for obstetric haemorrhage. Obstet Gynecol. 1985;66:353-6.

Motwani MN, Sheth J, Narvekar NM, Purandene MC, Hansotia MD. Maternal mortality resulting from antepartum hemorrhage - Review of 20 years. J Obstet Gynecol India. 1989;39:364-6.

Dutt DC. Antepartum haemorrhage. In: Hiralal Konar, editor. Textbook of Obstetrics. 6th ed. New Central Book Agency, Calcutta; 2004:243-61.

Downloads

Published

2016-12-16

Issue

Section

Original Research Articles