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Introduction: Abruptio placenta is a serious condition that increases maternal and neonatal morbidity and mortality. The incidence of abruption placenta is between 0.49% -1.8%. Primary cause of abruption is not known but the main precipitating and predisposing factors of abruption are age, parity, anemia, poor nutrition, pregnancy induced hypertension, eclampsia, gestational diabetes mellitus, preterm premature rupture of membrane, and previous medical termination of pregnancy. Methodology:It is a retrospective observational study done by analyzing the case sheets of abruption placenta in tertiary care hospital from January 2020 to December 2020. All those patients of antepartum hemorrhage presenting directly as typical cases of abruption placenta were included. Also, those cases in which placenta previa and other causes were ruled out after clinical, per speculum examination and/or USG examination were ruled out. Result:The total number of abruption placenta collected during this period was 21. We found 38% patients with chronic hypertension, 33 % of patients with severe preeclampsia, 14% with eclampsia, 15% were normotensive. Advanced maternal age and multiparity were also the risk factors of abruption placenta. Conclusion: Antenatal care which identifies the risk factors like PIH plays an important role in decreasing the incidence of abruption placenta. Early detection and active management will reduce morbidity.
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Background: Abruptio placentae is very frequently seen in our population. Few studies have reported maternal and fetal morbidity and mortality associated with this condition. No work has been done on abruptio placentae in our setup. The data generated will help to improve maternal and fetal morbidity and mortality by planning prompt management of future cases of placental abruption. Objective of this study was to study possible etiological factors of abruptio placentae, analyse maternal outcome, perinatal outcome in the form of maternal morbidity and mortality and discuss possible preventive measures and future management optionMethods: The retrospective observational study it was included all cases presenting with ante partum haemorrhage during the study period. Subjects selected for the study were all cases diagnosed as having abruptio placentae. All other causes of APH like placenta previa and other extraplacental causes were excluded.Results: In the present study incidence of abruptio placentae is higher in 25-30 year that were 42.5% and more in 2nd gravida patient. PIH was accounting for 50%, most of the patients (95%) were anaemic at admission and majority of them required blood transfusion.one maternal mortality (2.5%) occurred, perinatal mortality was 75%.Conclusions: Abruptio placentae serious condition with manifestation of significant maternal and perinatal morbidity and mortality. Complications can be reduced by provisional antenatal care to every woman and with improvement in medical facilities, availability of blood transfusion, proper management of shock. With liberalization of caesarean section, the rate of maternal morbidity and mortality is gradually on the decline.
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Background: Abruptio placenta is one of the common cause of antepartum haemorrhage and is defined as premature separation of normally implanted placenta. It is more common in second half of pregnancy. Abruptio placenta is serious complication of pregnancy and causes high maternal and neonatal morbidity and mortality.Methods: This retrospective study of abruptio and its maternal and perinatal outcome was carried out between July 2016 and October 2017 at Rama Medical College Hospital and research centre.Results: Incidence of Abruptio placenta is 1.6%. It is most common in the women of age group 30-35 years. 75% of cases were associated with severe pre-eclampsia. Live births were 75% while stillbirths were 25%. PPH occurred in 30% of cases. DIC accounts for 25% of the complication.Conclusions: Abruptio placenta is life threatening complication of pregnancy and it is associated with poor maternal and fetal outcome if not managed appropriately. Hence early diagnosis and prompt resuscitative measures would prevent both perinatal and maternal mortality and morbidity.
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Background: Antepartum haemorrhage (APH) as one of the major obstetric emergencies contributing greatly to maternal and fetal morbidity and mortality is of serious concern in the developing world. A retrospective analysis of the APH cases and evaluation of its impact on fetal and maternal outcomes was conducted.Methods: A retrospective study of cases managed between January 2013 and December 2014 at the University College Hospital Ibadan; all cases at a minimum of 28 weeks of gestation with antepartum bleeding were selected. Data was retrieved from the hospital records.Results: Around 5.8% prevalence rate of APH was documented during the study period with placental abruption and placenta praevia accounting for 46.8% and 39.2% of these cases respectively. Only 28.5% of cases were booked. Three-fifths of the women had anemia, 17.7% suffered hypovolemic shock, 33.9% also had primary PPH while 4 out of every 10 (39.8%) were transfused with blood. Seven out of every ten premature deliveries (prior to 34weeks gestation) were due to placental abruption with p value of <0.001. There were 2 maternal deaths (1%), 61 (31%) still births and 11 (5.6%) early neonatal deaths giving a perinatal mortality rate of 35.6%.Conclusions: Antepartum hemorrhage was associated with poor maternal and neonatal outcome in this study. There is need to improve on infrastructures, such as functional blood banks, appropriate antenatal care and referral system in our health facilities to be able to cope with increasing challenges of this obstetric hemorrhage.
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Background: Antepartum haemorrhage, a life-threatening event, is defined as bleeding per vaginum occurring after the fetus has reached the period of viability, considered to be 20 weeks in developed countries and 28 weeks in countries with low resource settings. We evaluated the consequences of antepartum haemorrhage, their maternal and perinatal outcome so as to outline the proper management of patient in order to improve both maternal and perinatal morbidity and mortality.Methods: This one-year prospective study totaled 133 cases of APH fulfilling the inclusion criteria were studied. Data was recorded on the MS excel sheet for further analysis and processing.Results: Total 6693 deliveries were conducted out of which 133 presented as APH and incidence of APH was found out to be 1.98%. Placenta previa was most common. APH was commonly associated with multigravida and most cases were in age group of 26-30 years. Most of the PP and abruption cases were admitted at 34-37 weeks and 31-33 weeks respectively. High risk factors included previous LSCS and D and C, hypertension, multiple pregnancies and malpresentations. Most of the patients underwent preterm LSCS. Most fetal complications were due to prematurity. 58.6% patients were transfused blood. Overall perinatal mortality was 20.1% and maternal mortality was zero.Conclusions: Early diagnoses, timely referrals and transfusion facilities along with trained team of doctors with well-equipped ICU facility goes a long way in avoiding APH related maternak and fetal complications.
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Background: Oral cancer being one of the most common malignancies in the low-income group in India. It usually presents in an advanced stage limiting treatment options. The mainstays of treatment being surgery and radiotherapy both being lifestyle changing procedures. Aims and objectives: The purpose of this study is to evaluate the quality of life for oral cancer survivors after surgery in comparison with radiotherapy using ICF questionnaire Materials and methods: Oral cancer patients who underwent surgery (25 patients) and Radiotherapy (25 patients) in Stanley medical college for stage 1 and stage 2 lesions of oral carcinoma for past 3 Years (2013-2015) were enrolled. Results: The study showed that surgery as primary therapy provided a better quality of life than radiotherapy alone in the treatment of oral cancer patients. Conclusion: After comparing the results primary surgery for oral malignancy seems to be the treatment of choice as long as the tumor is amenable to surgical resection. Radiotherapy though resulting in a lower quality of life is very efficacious for unresectable tumors.
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Background: The Objectives of the present study are to assess the risk factors associated with antepartum haemorrhage (APH), maternal morbidity & mortality due to APH and its perinatal outcome in APH. Methods: This study was an analytical retrospective study conducted at NIMS University and Medical College, Jaipur over the duration of one year from July 2013-July 2014 over 100 cases of APH admitted in the hospital. Results: Among the 100 cases of APH the types observed were, placenta praevia: 39, abruptio placenta: 31, indeterminate causes: 25 and extra placental causes: 5. Maternal mortality out of 39 cases of placenta praevia was 1 and out of 31 cases of abruptio placentae was again 1. Perinatal mortality was 10% in placenta praevia and 19% in abruptio placentae. Conclusipn: APH is a major cause of maternal and perinatal mortality & morbidity, which can be prevented, by early registration, regular antenatal care, early detection of high-risk cases, early referral, better blood bank and OT facilities, improved intra-operative and postoperative care and better neonatal intensive care.
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Background: Obstetric emergencies faced in India are much different from those faced by the western world. Out of them, Abruption leading to hemorrhagic shock is a major obstetric emergency, which requires adequate management to avoid catastrophic events including maternal death. Aim: To assess the various modalities of treatment for abruption and its outcome, to assess maternal and perinatal outcome in patients with abruption, to determine the association and influence of various maternal factors on the outcome of pregnancy. Materials and methods: The study was conducted at GMH, Nayapool which serves as a tertiary referral Center having approximately 18000-24000 deliveries per annum. The study was conducted during June, 2006 to July-2007. During this period there were 18950 deliveries. Out of this 296 cases were selected. Results: Out of 18,000 deliveries, 1.64% (n-296) of the patients were complicated by abruption. The mean maternal age was 22-25 years with maximum incidence in both extremes of age. (20-25 years64.80%, 31-35 years-28.37%). Multiparous women (83.10%) were more affected compared to primigravida (16.89%). A staggering 89.86% or women had no antenatal care and 91.21% of patients belonged to low socio-economic status. 41.21% of women were in 28-32wks of gestation and 35.81% were in 32- 36 weeks. Bleeding per vaginum was the presenting complaint in 89% of patients. 66.22% of patients came with IUD. Maternal complications were frequent. There were 6 maternal deaths, 4 due to hypovolemic shock, 1 due to DIC, 1 due to status Eclampticus. Duration of time between onset of bleeding and seeking medical advice was significant. 2 patients developed PPH. The average induction-delivery interval was 5.2hrs, 82.43% of patients had vaginal delivery and Cesarean P. Renuka, K. Aruna Kumari, Akhila. Maternal and perinatal outcome in abruptio placenta – Study at teaching hospital. IAIM, 2016; 3(10): 111-116. Page 112 section was done in 17.56% of patients. 62.5% of patients received blood transfusion and 55.74% of patients were given FFP's Maternal mortality rate was 2.36% Perinatal Mortality was 61%. Out of these 66.21% of the patients came with IUD, 7.43% had early neonatal deaths, 7.42% had stillbirths. Conclusion: The possibility of abruptio placentae should be considered by the clinician when managing pregnant women with any of those characteristics. Abruptio placentae should be managed in centers where there is advanced maternal and neonatal facilities.
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Aim: To determine the incidence, predisposing factors, clinical presentation and perinatal and maternal outcome of patients managed for abruptio placenta. Study Design: A retrospective review. Place and Duration of Study: Department of Obstetrics and Gynaecology, Niger Delta University Teaching Hospital, Okolobiri between January 2009 and December 2013. Materials and Methods: Data were collected from records of all patients presenting with abruptio placenta. Information extracted from the records included demographics, parity, gestational age, clinical presentation, risk factors for abruptio placenta, complications, and perinatal and maternal outcome. Data analysis was performed with Epi info version 6.04d. The results are presented as means with standard deviations, percentages, rates and proportions. Association between maternal age and selected obstetric and neonatal variables were assessed using the chi-square and the twotailed Fisher exact test. Results: A total of 40 cases of abruptio placenta were seen out of 2,736 deliveries giving an incidence of 1.46%. Age did not significantly affect the incidence of abruptio placenta in this study (p=0.13). High parity was significantly associated with abruptio placenta (p = 0.02). Unbooked status and Low socio-economic class were both significantly associated with abruptio placenta (p<0.001). Possible abdominal trauma due to traditional abdominal massage was documented in 26 (72.2%) cases and was significantly associated with abruptio placenta (p<0.01). There was one maternal death giving a case fatality rate of 2.8%. There were 19 perinatal deaths giving a perinatal mortality rate of 527.7 per 1000 births. Conclusion: Lack of antenatal care and traditional abdominal massage during pregnancy are major predisposing factors to abruptio placenta in our environment. Perinatal mortality associated with abruption placenta is high.
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Objective To explore the early diagnosis of placental abruption and the control measures.Methods Retrospective analysis of our hospital from January 2001 to January 2011 during the 62 patients admitted to the placental abruption.Results Gestational hypertension,trauma and sexual intercourse,premature rupture of membranes for the three main causes; clinical manifestations of lumbar pain,vaginal bleeding,abnormal fetal heart rate and fetal movement,Palace board hard and tenderness,bloody amniotic fluid,etc.;take natural childbirth 9 cases,seven cases of vaginal delivery,cesarean section 42 cases,hip midwifery 4;43 cases of postpartum hemorrhage,26 cases of uteroplacental apoplexy,4 routine hysterectomy; normal newborn delivery,31 cases of neonatal asphyxia,22 cases of fetal death in 3 cases,perinatal child death in 6 cases,perinatal child mortality 9.7％.Conclusion Emphasis on pathogenesis and clinical manifestations,combined with auxiliary B ultrasonic examination to help the early diagnosis of placental abruption.Aggressive treatment of hypertensive disorders in pregnancy,to avoid injury prevention and treatment of placental abruption and premature rupture of membranes is an effective measure.
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OBJECTIVE: To evaluate for the clinical analysis on abruptio placenta, we examined its incidence, diagnostic methods, symptom and sign, perinatal mortality, and recurrence rate. METHODS: We reviewed the medical records of the 396 cases of abruptio placenta among 72.580 deliveries, from Jan. 1, 1990 to Dec. 31, 1997, at St. Mary, Kang Nam St. Mary, and Holy Family Hospital of Catholic University. RESULTS: The total incidence of abruptio placenta was 0.51%, the incidence plotted by age from 1993 to 1997 has shown that the age incidence was higher in 20-24years old(0.7%), and over 35years old (0.8%). 42.5% of the case occurred between 32 to 37weeks of gestational age, 39.6% was over 37weeks. 38% of the patient was diagnosed before delivery with ultrasonography and the most common complaint was vaginal bleeding. The complication of abruptio placenta is as follows, Couvelaire uterus occurred in 26cases(7.0 %), DIC in 10cases(2.7 %), ARF in 4cases (1.1 %), and uterine rupture in 1case(0.3 %). Perinatal mortality including 41cases of stillbirth was 19.9 %(73cases) but no maternal death was noted. A history of abruptio placenta increased risk of a similar incident in a subsequent pregnancy by 19 cases(4.6 %: 9.0 fold)complicated with 13 cases of pregnancy induced hypertension(76.5 %). CONCLUSION: The incidence of abruptio placenta plotted by age have shown higher in 20-25years old and over 35 years old, hypertensive women experienced abruptio placenta are more likely to have higher graded recurrent rate in subsequent pregnancy, and abruptio placenta is major obstetric bleeding disease causing serious maternal and fetal complication.
Sujets)
Adulte , Femelle , Humains , Grossesse , Dacarbazine , Âge gestationnel , Hémorragie , Hypertension artérielle , Incidence , Décès maternel , Dossiers médicaux , Mortalité périnatale , Placenta , Récidive , Mortinatalité , Échographie , Hémorragie utérine , Rupture utérine , UtérusRésumé
A retrospective study on abruptio placenta was conducted at the Institute for the Protection of Mother and Newborn. Seventy-one among 40,962 deliveries between 1995 and 1999 were defined as abruptio placenta, giving a rate of 0.17%. Of the abruptio placenta cases, moderate and severe conditions were more common, accounting for 73.2%. A majority of the abruptio placenta cases (88.7%) was managed by cesarean section. Hysterectomy accounted for 33.8% among abruptio placenta cases. The study showed that obstetrical intervention of choice in the moderate and severe conditions is cesarean section.