Abruptio placenta and adverse pregnancy outcome.

OBJECTIVE To determine the risk factors in pregnancies complicated with abruptio placenta METHODS Case-control study. The study was conducted at department of Obstetrics and Gynecology Unit 3, Civil Hospital, Dow University of Health Sciences Karachi. The study period was from January to December 2008. All pregnant women who were diagnosed with abruptio placenta after 28 weeks of gestation were included in the study. They were compared with women who had live birth during the study period. This group was taken as controls. Both groups were identified from the admission, labour room registers. RESULTS Total number of deliveries during the study period was 2610. Patients identified with abrupio placenta were 81, giving a frequency of 3.75%. Majority (44%) of women were between 26-30 years of age group. Forty three (54%) of the women were second, third or fourth gravida. The mean gestational age was 34 +/- 4.21 weeks. Forty one (51%) delivered preterm before 37 weeks and 40 (49%) delivered at or after 37 completed weeks of gestation. Vaginal delivery was the main mode of delivery, followed by Caesarean section. Vaginal bleeding was the most common clinical finding seen in 80% (68/81) women, followed by blood stained amniotic fluid in 45% (37/81). Foetal heart sounds were absent on admission in 65% (53/81). There were two maternal deaths due to postpartum haemorrhage. The perinatal mortality rate was 66% (54/81). Parity and gestational age were found to be significant risk factors for abruptio placentae (p < 0.031 and p < 0.001 respectively). CONCLUSION Abruptio placenta is associated with poor maternal and foetal outcomes.