Maternal and Fetal Outcome in Cases of Placental Abruption

Background: Placental abruption is a major contributor to obstetrical haemorrhage and a major cause of perinatal mortality in developing countries. This has been done to an attempt to recognize this condition at an earlier stage, prevent its complications and properly manage the complications if they do occur. Aim: To determine maternal and fetal outcome in females with placental abruption. Methods: Hundred patients with confirmed diagnosis of placental abruption were divided in three categories according to the grade of placental abruption. Their baseline investigations including blood group, haemoglobin and coagulation profile i.e. partial thromboplastin time, activated partial thromboplastin time, serum fibrinogen and FDP's were performed and recorded for each category separately. The effect of each grade of abruption was studied on maternal and fetal outcome as well as extent of coagulation disturbance. Results: The results of the study show that 66% babies were delivered alive and 34% were IUD/stillbirth. Gestational age at presentation was important in fetal outcome. Out of 30 babies presenting before 32 weeks of gestation 66% were IUD/stillbirth. 58% patients delivered vaginally and 42% had caesarean section. 32% patients had grade I abruption, 34% patients had grade 3 abruption. 18% patients had post-partum haemorrhage. Conclusion: All professionals working in labour ward must be aware of the causes, presentation and complications of disease and appropriate measures taken in time can help reduce the maternal and neonatal morbidity and mortality. Keywords: Placental abruption, maternal outcome, foetal outcome, coagulation disturbance

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DIAGNOSTIC PERFORMANCE OF ULTRASONOGRAPHY FOR DETECTION OF ABRUPTION AND ITS CLINICAL CORRELATION AND MATERNAL AND FETAL OUTCOME

10.36106/ijsr/0329103 ◽

2021 ◽

pp. 5-7

Author(s):

Jeel Patel ◽

Dhruvi Umarwadia ◽

Ishit Shah ◽

Narottam Patel

Keyword(s):

Perinatal Mortality ◽

Predictive Value ◽

Diagnostic Performance ◽

Placental Abruption ◽

Fetal Outcome ◽

Medical Sciences ◽

Predictive Values ◽

Mortality And Morbidity ◽

Obstetric Management ◽

Nicu Admission

Placental abruption complicates about 1% of singleton pregnancies and is an important cause of perinatal mortality and morbidity. Though sensitivity and reliability of ultrasound are poor for detecting or excluding placental abruption, because of the advances in ultrasound resolution, imaging and interpretation, sensitivity of ultrasound is better than what was reported previously. To determine the diagnostic performance of Aim: Ultrasonography (USG) for the detection of placental abruption and whether sonographic results correlate with maternal and foetal management and outcome Sixty patients with clinical diagnosis of placental abruption we Materials and Methods: re studied in the Obstetrics and Gynaecology Department of Gujarat Adani Institute of Medical Sciences, Bhuj over a period of 6 months. These patients underwent ultrasonography for conrmation. Obstetric and neonatal outcome and sonographic results were compared and reviewed. Sonographic sensitivity and specicity and positive and negative predictive values were calculated. Incidence of abruption in present study was 3.05% (56 Results: patients out of 1834 total deliveries). Sensitivity of ultrasonography in the diagnosis of abruption was 57% while its specicity was 100% with a positive predictive value of 100% and a 14% negative predictive value. An 87.5% of patients(28 out of 32) with a positive USG nding of abruption had Intrauterine foetal Death (IUD)/still birth while 91.6% of patients (22 out of 24) with negative USG ndings of abruption gave birth to babies who required NICU admission. Sonography has a poor sensitivity for diagnosing placental abrupt Conclusion: ion, even though it has a high specicity and PPV. In a positive sonographic result, maternal morbidity and perinatal mortality are high which needs aggressive obstetric management as compared to the normal sonography. In case of a negative sonographic nding but a strong clinical suspicion of abruption if Obstetric intervention is made in due time, foetal as well as maternal outcome are better

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Placental abruption and placental hemorrhage: correlation of sonographic findings with fetal outcome.

Radiology ◽

10.1148/radiology.164.2.3299486 ◽

1987 ◽

Vol 164 (2) ◽

pp. 357-361 ◽

Cited By ~ 57

Author(s):

D A Nyberg ◽

L A Mack ◽

T J Benedetti ◽

D R Cyr ◽

W P Schuman

Keyword(s):

Placental Abruption ◽

Fetal Outcome

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EXCESSIVE CALCIFICATION OF PLACENTA;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.05.1452 ◽

2013 ◽

Vol 20 (05) ◽

pp. 743-751

Author(s):

PUSHPA GOSWAMI ◽

SAMREEN MEMON ◽

MUHAMMAD ASLAM CHANNA ◽

Hemlata Rathi

Keyword(s):

Placental Abruption ◽

Histological Study ◽

Normal Pregnancy ◽

Fetal Outcome ◽

University Hospital ◽

Control Group ◽

Abruptio Placentae ◽

New Born ◽

Study Results ◽

Induced Hypertension

Objective: To examine the morphological change due to excessive calcification of placenta of pregnancies complicated bypregnancy induced hypertension (PIH) and placental Abruption and its relation with fetal outcome. Study design: Case control type ofstudy. Place and duration: This study was conducted from June 2008 to July 2009 at the department of Anatomy of Liaquat University ofMedical & Health Sciences Jamshoro. Material and Methods: One hundred twenty placentae were collected from labor room andgynecology operation theatre of Liaquat University Hospital. Forty placentae from parturients that had pregnancy induced hypertension(PIH), forty from parturient having placental abruption & forty placentae of normal pregnancy (Control Group). Age of all parturients isbetween 17 to 32 years. Fetal outcome and data was recorded. Weight and diameter of Placentae were measured. Approximately five cmpiece of placenta was taken and processed for histological study. Results: The weight of placenta in control group were 450 to 650 gmwith a mean weight of 526.25± 8.414 gm and their diameter from 19 to 24 cm with a mean of 21.225±0.2148cm. In PIH group weight ofplacenta was from 200 to 550gm with a mean weight of 432.25 ± 11.889gm and their diameter ranges from 10 to 16cms with amean14.208 ± 0.1914cm. In placental abruption group the weight of placenta ranges from 180 to 400 gm with a mean weight of 284.88±9.084 gms and diameter ranges from 10 to 14cms with mean 13.070 ± 0.2504 cm. The difference in weight and diameter of placentain PIH and abruptio placentae was found statistically significant when compared with weight and diameter of normal placentae. Theweight of new born babies in control group was 1.8 kg to 3.6 kg mean weight of 2.790± 0.0689kg. In PIH group, the fetal weight was 1.4kg to 3.0 kg with a mean weight of 2.195 ±0.0703kg. In abruptio placentae group, the weight of new born baby ranges from 1.0 kg to2.8kg with a mean weight of 1.898 ± 0.0660 kg. Conclusions: Fetal outcome in cases of PIH and in abruptio placentae was poor ascompared to control group.

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Placental abruption an obstetric emergency: management and outcomes in 180 cases

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20203294 ◽

2020 ◽

Vol 9 (8) ◽

pp. 3188

Author(s):

Pratibha Devabhaktuni ◽

Aruna Kumari Konkathi

Keyword(s):

Placental Abruption ◽

Fetal Outcome ◽

Fresh Frozen Plasma ◽

Perinatal Deaths ◽

Neonatal Deaths ◽

Still Births ◽

Vaginal Deliveries ◽

Number Of Patients ◽

Fresh Frozen ◽

Fetal Wellbeing

Background: During a period of eight months, 180 cases of abruption that occurred from January 2007 to August 2007 at GMH, Nayapool, Hyderabad were analysed. Total number of deliveries during the study period of eight months were 14004. Incidence of abruption cases delivered was - 1.3%. In this series 88% were unbooked in our hospital, were referrals. Objective of this study was to study maternal fetal outcome of placental abruption.Methods: Initial clinical assessment, investigations for maternal fetal wellbeing, expedite delivery, manage complications as per accepted protocol. In this series of cases, ARM was done in 85 cases (47.22%), ARM was done and oxytocin drip was started in 36 (20%), ARM was done and PGE1 tablet 25 mcg. was inserted in the vagina in 39 (21.66%).Results: The bleeding was revealed in 146-81.1% and concealed in 34-18.88%. The number of cases with hypertension complicating pregnancy were 102-57%, hypotension in 16-8.88%, prolonged clotting time 13-7.22%, the number of patients who received blood transfusions were 105 (58.3%), number of patients who received fresh frozen plasma, FFP transfusions were 65-36.11%. Taken for LSCS at admission were - 46. Failure to progress after ARM or other methods of labour augmentation were 20 cases. The total number of caesarean deliveries were 66/180 - (36.66%), number of vaginal deliveries were 114 (63.33%). Perinatal outcome: the total number of intra uterine fetal deaths (IUFD) at admission were 103-57.2%. The number of still births were 7-3.8%. Live born babies were 70- 38.8%. Neonatal deaths were 11-6.1% and total perinatal deaths were 121-67.2%. (IUFD at admission-103, + still births - 7, + neonatal deaths - 11=121 perinatal deaths. There were five maternal deaths in 180 cases of placental abruption, 2.7% mortality.Conclusions: Need to consider measures to reduce the occurrence of this condition.

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Comparison of Pregnancy outcome among Placenta Previa and Abruption

Annals of King Edward Medical University ◽

10.21649/akemu.v11i1.992 ◽

2016 ◽

Vol 11 (1) ◽

Author(s):

Shamsa Humayun ◽

Fehmida Nahid

Keyword(s):

Renal Failure ◽

Cesarean Section ◽

Pregnancy Outcome ◽

Placental Abruption ◽

Placenta Previa ◽

Neonatal Morbidity ◽

Fetal Outcome ◽

Operative Delivery ◽

Cesarean Hysterectomy ◽

Poor Pregnancy Outcome

The objective of study was to compare the pregnancy outcome among placenta previa& placental abruption. Study Design: A retrospective analysis of pregnancies complicated by placenta previa or abruption, from January 2003 to December 2003. Results A poor fetal outcome was more frequent in cases of abruption (56.6%) than placenta previa (20%) Prematurity was significantly high in abruption (63.3)%than in placenta previa (40%).cesarean section rate was high in placenta previa(98%) compared to (20%) in abruption. Renal failure PPH and cesarean hysterectomy were the major complications in both groups. Conclusion: Women with abruption had poor pregnancy outcome than placenta previa They were more likely to deliver prematurely with high neonatal morbidity and mortality. Operative delivery was more common in placenta previa.

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Fetal Outcome varies with different grades of Placental Abruption

Annals of King Edward Medical University ◽

10.21649/akemu.v9i1.1317 ◽

2016 ◽

Vol 9 (1) ◽

Author(s):

Zaheera Saadia ◽

Aamir Zaman Khan ◽

Fehmida Nahid

Keyword(s):

Placental Abruption ◽

Good Condition ◽

Fetal Outcome ◽

P Value ◽

Intrauterine Death ◽

Aggressive Approach ◽

Time Period ◽

Grade 3 ◽

One Year ◽

A Prospective Study

This is a prospective study carried out in Gynae unit-1 of Sir Ganga Ram Hospital, Lahore over a time period of one year. We aimed to find out the prevalence of abruptio placenta in the hospital population and compare the fetal outcome with different grades of placental abruption. Student t test was applied to assess the degree of significance. P value < 0.05 was considered as significant. Complications observed were intrauterine death (IUD), Intrauterine growth retardation (IUGR), Prematurity and fetal anemia. Placental abruption accounted for 2% of hospital obstetrical population. Adverse fetal outcome was observed with Grade 3-4 abruption as compared to abruption of Grade 0-1. Statistically significant numbers of fetuses had no complication with Grade 0-1 abruption and were delivered in good condition (table-1). We concluded that a more aggressive approach is required to manage abruption of Grade 3-4 and observational strategy should be considered for Grade 0-1.

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Hypercoagulable Thrombophilic Defect and Hyperhomocysteinemia with Recurrent Pregnancy Loss

The Journal of Medical Sciences ◽

10.5005/jp-journals-10045-0037 ◽

2016 ◽

Vol 2 (3) ◽

pp. 50-52

Author(s):

PG Rooplata ◽

Nagendra Prasad

Keyword(s):

Pregnancy Loss ◽

Intrauterine Growth Retardation ◽

Recurrent Pregnancy Loss ◽

Placental Abruption ◽

Fetal Outcome ◽

Intrauterine Fetal Death ◽

Placental Perfusion ◽

Intrauterine Growth ◽

Changes In Pregnancy ◽

Physiological Changes In Pregnancy

ABSTRACT Successful fetal outcome in any pregnancy is dependent on adequate placental circulation. Normal physiological changes in pregnancy produce a hypercoagulable state. Placental vasculature abnormalities may result in a number of gestational defects. They also can cause loss of pregnancy, intrauterine fetal death, intrauterine growth retardation, placental abruption, and preeclampsia. Hereditary thrombophilias are usually undiagnosed because most carriers are asymptomatic. Placental perfusion may be compromised by increased thrombosis that leads to pregnancy complications and recurrent pregnancy loss (RPL). We report a case of hypercoagulable thrombophilic defect and hyperhomocysteinemia with RPL. How to cite this article Rooplata PG, Nagarathnamma R, Prasad N. Hypercoagulable Thrombophilic Defect and Hyperhomocysteinemia with Recurrent Pregnancy Loss. J Med Sci 2016;2(3):50-52.

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