A STUDY OF ANTEPARTUM HAEMORRHAGE AND ITS MATERNAL AND NEONATAL OUTCOME AT TERTIARY CARE HOSPITAL

2021 ◽  
pp. 12-13
Author(s):  
Sukanya Ethirajan ◽  
Padmapriya Ramasamy ◽  
Srija Manoharan

Antepartum haemorrhage (APH) is an obstetric emergency contributing to a signicant amount of perinatal & maternal morbidity and mortality (1). It is dened as bleeding from or into the genital tract after 28 weeks of gestation (2). It occurs in 2-5% of pregnancies and is an important cause of fetal and maternal mortality (3). Thirty percent of maternal deaths are caused by antepartum haemorrhage of which 50% are associated with avoidable factors (4). In India, the prevalence of antepartum haemorrhage is reported to be 18.8 % (5). The main causes of APH are placenta previa, abruptio placentae, indeterminate cause or local causes of genital tract.

Author(s):  
Sonal Bhuyar ◽  
Neha Dharmale

Background: Placenta previa is one of the life-threatening complications in obstetrics which affects maternal and neonatal outcome. Now-a-days its incidence is increasing due to previous operative procedures. The objective of the present study was to study out maternal and fetal outcome in various types of placenta previa.Methods: A prospective study was conducted in our tertiary care hospital on 78 patients in order to know the cause and outcome of placenta previa.Results: Early termination was carried out in major PP group due to APH. 13 out of 17 patients presenting with APH had major degree of PP. Abnormal lie and presentation are commonly seen in cases of PP however cephalic constituted 83.3% cases of fetal presentations in present study followed by breech 10.2%, oblique 3.9%, face 1.3% and transverse 1.3%. In this study, 92.2% neonates were born alive while neonatal death and intrauterine death (IUD) was observed in 5.2% and 2.6% neonates respectively.Conclusions: Combined efforts for prevention of risk factors for PP, timely diagnosis and planned institutional deliveries can only reduce the morbidity and mortality associated with PP.


Author(s):  
Pamulaparthi Bindu Reddy ◽  
Gurram Swetha Reddy

Background: Placenta previa refers to the presence of placental tissue that extends over the internal cervical os.  Placenta previa is linked to maternal hypovolemia, anaemia, and long hospital stay and with prematurity, low birth weight, low APGAR score in newborn. So it is very important to identify the condition at an early date to warn the condition thereby reducing the maternal and foetal morbidity and mortality. The present study was aimed to estimate the prevalence of PP, its associated predisposing risk factors and maternal morbidity, mortality and the perinatal outcome.Methods: A prospective observational study for two years was conducted at a tertiary care hospital. Pregnant mothers with >28 weeks of age with H/o ante partum haemorrhage were screened for placenta previa, confirmed by ultra sonography and included in the study. Clinical history, obstetric examination was done and followed up till the delivery. Maternal and foetal outcomes were recorded. Data analyzed by using SPSS version 20.Results: 1.4% incidence of PP was noted, mean age of group was 29.17±1.6 years. Age group of 21-30 years, multiparity Gravida 2-4, previous history of caesarean section and less number of ante natal checkups were significant risk factors and LSCS was most common outcome. Prematurity, low birth weight and APGAR <7 score for 1 minute was common foetal outcomes.Conclusions: Our study strongly suggests foetal surveillance programmes in cases of placenta previa. Measures should be made to bring awareness about PP, in urban slums and to increase medical checkups regularly. Making USG mandatory during every ANC and referral of cases of PP to tertiary care centres would definitely reduce the chances of morbidity and mortality.


2014 ◽  
Vol 13 (8) ◽  
pp. 49-53
Author(s):  
Dr. Chandrakanta Sulaniya ◽  
◽  
Dr Pawan Kumar Sulaniya ◽  
Dr. Kusum Lata Gaur ◽  
Dr Anju Sharma ◽  
...  

2017 ◽  
Vol 15 (1) ◽  
pp. 2-4
Author(s):  
Husneyara Haque ◽  
Upendra Pandit

Introduction: Placenta previa is an obstetric complication which causes considerable maternal and fetal morbidity and mortality during pregnancy. This study is done with the objective to find out the clinico-demographic factors associated with placenta previa and to analyze maternal and perinatal outcome in these cases. Methods: This was a retrospective study done in the department of Obstetrics and Gynecology of Nepalgunj Medical College Teaching Hospital, Nepalgunj, a tertiary care hospital from Midwestern Nepal. Relevant data were retrieved from maternity register from June 2015 to May 2017. All women who had undergone caesarean section for placenta previa were included in this study. Result: Out of total 5812 deliveries during the study period there were 50 caesarian sections done for placenta previa which is 0.86% of total deliveries. Maximum number of mothers belonged to 26- 30 years of age group. Commonest type of placenta previa was minor type. About 72% were multiparous. 20% had previous LSCS and 24% had previous abortion. Postpartum hemorrhage was present in 36% mothers and 32% received blood transfusion. About 64% new born were preterm and low birth weight. 34% babies had less than 7 apgar score at 5 min. Still births were 6%. Conclusion: Placenta previa poses greater risk and need of blood transfusion to mother as well as birth of preterm and low birth weight babies which leads to perinatal morbidity and mortality. Timely diagnosis, regular antenatal check up and effective management may improve pregnancy outcome.


Author(s):  
Sasmita Behuria ◽  
Jyoti Narayan Puhan ◽  
Subhra Ghosh ◽  
Bhabani Sankar Nayak

Background: Pregnancy, although being considered a physiological state, carries risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labor, or thereafter. The major causes of maternal mortality are mostly preventable through regular antenatal check-up, proper diagnosis, and management of labor complications. Therefore, the factors at different levels affecting the use of these services need to be clearly understood. The aim is to study the incidence of MMR, assess the epidemiological aspects, causes of maternal mortality and avoidable factors that can prevent maternal deaths.Methods: A retrospective hospital-based study was conducted in obstetrics and gynecology department, SLN MCH, a tertiary care referral hospital in a tribal area of southern Odisha over a period of 2 years from April 2017 to March 2019.Results: A total of 108 deaths were analyzed over 2 years period and MMR was calculated to be 1124/1 lakh live births. Most of the maternal deaths occurred in the age group of 20-24 years (35.1%), majority of maternal deaths were observed in multipara (46.3%), 70.3% deaths occurred within 24 hours of admission. Hypertensive disorders in pregnancy (37%) were the leading direct cause followed by hemorrhage (14.8%) and sepsis (11.1%). Among the indirect causes jaundice (7.4%) and anaemia (3.7%) were the leading cause.Conclusions: MMR in our study was very high as compared to national average of 167/1,00,000 live births, being a tertiary care hospital as most of the patients were referred from peripheral centers. Most maternal deaths are preventable by intensive health education, basic obstetric care for all, strengthening referral and communication system and emphasizing on overall safe motherhood.


2021 ◽  
Vol 15 (1) ◽  
pp. 69-72
Author(s):  
Sadia Kadir ◽  

Background: Grand multiparity considered as a risk factor of obstetrics because of the recorded complications linked to the condition. Grand multiparity typically considered as the distinctive reason for the raised, maternal and fetal morbidity and mortality because of expanded incidence of adverse outcome during pregnancy and birth. Objective: To determine frequency of antenatal complications in grand multipara. Study Design: Cross-sectional study. Settings: Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Centre, Karachi Pakistan. Duration: Study duration was six months from March 2016 September 2016. Methodology: Total 212 patients were included in this study. Anemia was taken as Hb of 11g/dl, PIH was taken as BP of >140/90mmHg after 20 weeks of gestation with or without proteinuria on two or more occasion 6 hours apart and placenta previa was confirmed via ultrasonography. All the information was collected via study proforma. Results: Patients mean age was 34.90±3.51 years. Most of the patients 96.7% had parity 5-9. Anemia was found 69.8% and pregnancy induced hypertension was 22.2%, while placenta previa was found to be 18.9%. Antenatal complications including anemia, pregnancy induced hypertension and placenta previa were found to be statistically insignificant according to age, parity and BMI, (p->0.05). Conclusion: Most common antenatal complication in this study was anemia followed by hypertension and placenta previa. Grand multiparity is at a greater risk of antenatal complications.


Author(s):  
Amruta R. Kulkarni ◽  
Arti S. Shirsath

Background: Antepartum haemorrhages are defined as bleeding from or into the genital tract after the period of viability untill delivery of the fetus. APH complicates 3-5% of pregnancies and is a leading cause of perinatal and maternal mortality worldwide. Objective of this study is to quantitate maternal morbidity, mortality and perinatal outcome in patients with APH at a tertiary care hospital.Methods: A retrospective observational study was carried out in the department of obstetrics and gynecology, Smt. Kashibai Navale medical college and general hospital, Pune. Patient information was obtained from the delivery records of 2018, 2019 and 2020. Patients presenting after the gestational age of 28 weeks with antepartum haemorrhage were included in the study.Results: Out of 100 cases of APH, abruptio placenta contributes to 60%, placenta previa to 37% and 3 cases were due to unknown cause. Overall maternal mortality was 3% and perinatal mortality was 23% in abruptio placentas compared to 13% in cases with placenta previa. Main cause of perinatal mortality was prematurity69%.Conclusions: Antepartum haemorrhage is one of the leading cause of perinatal mortality and morbidity. These cases should be deliverd at a centre with transfusion facility, NICU facility and by the obstetrician skilled in controlling intraoperative haemorrhage by stepwise devascularising sutures. Timely decision of uterine tamponade can also save few ceaserean hysterectomies.


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