Obstetrical prognosis after placental abruption

ABSTRACT

Placental abruption is the premature separation of normally situated placenta after 24 completed weeks of pregnancy and before delivery of a baby. It is self extending process with accumulation of blood clots leading to more separation of placenta. The study was conducted to assess the perinatal mortality, morbidity in relationship to the severity ofplacental abruption and to estimate the magnitude of abruption. It is a descriptive and observational study. The study was conducted in the department of obstetrics and gynaecology, Sir Ganga Ram Hospital, Lahore over a period of one year from May, 2009 to May 2010. A total of 80 patients with the diagnosis ofplacental abruption after 24 completed weeks of gestation were included in this study. Neonates were evaluated at the time of birth and followed upto 46 hours after birth. Among the 80 patients, only 14 were [17.5%] booked, while 66 [82.5%] remained unbooked. A total of 27 [33.75%] patients had pregnancy induced hypertension, 65 [81%] were anaemic. Polyhydramnios and multiple pregnancy were seen in 3 and 4 patients respectively. Majority of patients i.e. 47[58.75%] delivered by abdominal route. Regarding the fetal outcome alive born babies with placental abruption were 41 [51.25%] in which 23 [28.75%] were preterm and 18 [22.5%] were full term. Thirty six [45%] intrauterine dead fetus and in whome 25 [31%] were preterm and 11 [13.75%] were full term, only 3 were still births. Twenty four [30%] neonates required resuscitation, while 20 [25%] neonate were shifted to neonatal intensive care unit. latrogenic prematurity was the underlying cause of most complications. Perinatal morbidity and mortality is significantly high in patients of abruption placentae. Hypertension is a major predisposing factor for placental abruption