Risk factors and clinical outcome of placental abruption: a retrospective analysis.

OBJECTIVE To determine frequency, obstetrical risk factors and the subsequent feto-maternal outcome in women suffering from placental abruption. METHODS A retrospective case series study was carried out in the Department of Obstetrics and Gynaecology Unit One, Liaquat University Hospital Hyderabad, Pakistan from 1st January 2006 to 31st December 2006. All women with the diagnosis of placental abruption having more than 24 weeks gestation were included in the study. RESULTS Of the 2224 delivered women 106 (4.7%) had placental abruption. All of the 106 women were unbooked, with 67 (63%) in the age group 20-35 years, 68 (64%) belonged to rural areas. 98 (92%) patients were multiparous and 57 (54%) were preterm. The commonest medical disorders observed were anaemia in 84 (79%), Diabetes Mellitus in 8 (8%) and gestational hypertension in 8 (8%) patients. There were five maternal deaths, showing case fatality rate of 5%. The foetal prognosis was characterized by low birth weight seen in 74 (70%), low apgar score in 30 (28%) and high still birth rate in 54 (51%), constituting perinatal mortality rate of 25.62/1000 deliveries. CONCLUSION Abruptio placentae is associated with adverse maternal and foetal outcome. Multiparity, un-booked status, rural residence and maternal anaemia are important risk factors.