Incidence of placental abruption; morbidity / mortality associated with it

Objective: To determine the Incidence of Placental Abruption and the morbidity / mortality associated with it

Design: Prospective and Observational case Study

Setting and Duration: Department of Obstetrics and Gynecology, Liaquat University of Medical and Health Sciences Hyderabad, for a period of 15 months from January 2007 to March 2008

Patients and Methods: Among all the antenatal patients delivered during the period under review, those suffering from Placental abruption were entered into this study by completing a proforma for each patient. After history, examination and initial management, investigations were carried out. These patients were managed on case to case basis depending on the progression of abruption and delivery. After delivery whether spontaneous or by cesarean section the condition of mother and subsequent complications were recorded and results analyzed on SPSS version 10

Results: During the period 15 months, 2760 patients were admitted to labour room /labour ward and delivered. Among these, 100 patients had abruption making an incidence of 2.89% per year. According to the degree of abruption 33 had mild, 50 had moderate and 17 had severe abruption. 42% had spontaneous vaginal delivery, and 52% underwent cesarean section. 36% of Abruptio patients, developed complications like shock, PPH and DIC. One [1%] patient died in severe abruption

Conclusions: The incidence of Abruptio Placentae in this study is comparable to local studies and studies from developing countries, but is high in comparison to studies from developed countries. The maternal morbidity and mortality rate is not as high as in other studies

Placental abruption; frequency of its risk factors

To determine the frequency of risk factors associated with Placental Abruption. Prospective and Observational Case Study. Department of Obstetrics and Gynecology, Liaquat University of Medical and Health Sciences Hyderabad, for a period of 15 months from January 2006 to March 2007. All the antenatal patients/ pregnant ladies admitted to labour room /ward and delivered during the above mentioned period were scrutinized and those suffering from Abruptio Placentae were entered into this study by completing a proforma for each patient. The risk factors studied were; Age of Patient, Parity, past history of abruption, rural belonging, history of trauma, association with diabetes, hypertension, smoking and anemia. Results were analyzed on SPSS version 10. A total of 100 patients suffering from placental abruption were studied during 15 months period. The commonest age group was 30 years [47%]. Majority [54%] was multiparous, 66% belonged to rural population and among these, 2/3 were unbooked. Only one patient gave history of trauma. 5 patients had history of previous abruption. History of diabetes was present in only one patient, whereas 38% were hypertensive. Only 4 patients gave positive history of smoking. Anemia was the single most common factor present in 83% ladies. Age around 30 years, multiparity, hypertension, presence of anemia, rural belonging and previous abruption are the risk factors for placental abruption as per this study. No association of abruption has been found with trauma, diabetes or smoking in this study

Feto maternal outcome among abruptio placentae cases at a university hospital of Sindh

Objective: To determine fetomaternal outcome in women presenting with abruptio placentae at our setup. Design: A descriptive study. Setting: Department of Obstetrics and Gynecology Unit-II, Liaquat University Hospital Hyderabad, Sindh - Pakistan. Study was carried out from January to December 2007

Methods: All patients presenting with antepartum hemorrhage due to abruptio placentae at any gestational age after 28 weeks to term were included in the study. Women having bleeding due to causes other than abruption like placenta previa, vasa previa, carcinoma cervix and other local lesions were excluded. All the data collected through history, examination and investigations were recorded on a predesigned proforma. Data were analyzed using SPSS version 10.0

Results: Total number of cases admitted in labour ward was 2563. Forty-eight [1.87%] women had abruptio placentae. Maternal complications were postpartum hemorrhage [16.6%], disseminated intravascular coagulation [4.16%] and renal failure [6.25%]. Maternal death occurred in 4 women [8.33%]. Adverse fetal outcome was noted in severe cases of abruption. Still birth occurred in 41.6% cases

Conclusion: In our setup, frequency of abruptio placenta is comparable with local and international literature. Incidence of abruptio placenta is high in our women as most of the women belong to poor socio-economic class. Antenatal care plays an important role in decreasing the incidence of abruptio placenta

Meigs' syndrome

Meigs syndrome is a rare clinical condition commonly considered to be associated with malignant ovarian tumour. A case of unmarried female is presented who came with a slowly increasing abdominal mass. Clinical and ultrasonic investigations revealed a mobile, solid right adenexal tumour in the lower abdomen, along with ascites and pleural effusion of the right lung. The level of CA 125 was also raised. Diagnosis of Meigs syndrome was confirmed after surgical intervention. The tumour was successfully removed and pleural effusion disappeared 15 days after the intervention. Cytomorphologic study of both the tumour and ascitic fluid was negative for malignancy