DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20222616
Published: 2022-10-28

Maternal and perinatal outcome in antepartum haemorrhage patients attending tertiary care hospital in central India: a prospective observational study

Priyanka S. Anjankar, Sangeeta Ramteke

Abstract


Background: Antepartum haemorrhage (APH) is an emergency obstetrical condition that accounts for 2-5% of pregnancies and contributes to high level of maternal and perinatal mortality and morbidity. The present study was undertaken to assess the incidence of APH and to determine the maternal and fetal outcome in women with APH.

Methods: This study was conducted in 130 women diagnosed with APH (gestational age ≥28 weeks) admitted in the department of obstetrics and gynaecology, at tertiary care hospital in central India over a period of 18 months from January 2020 to June 2021.

Results: The overall incidence of APH was 1.09% and majority of them had abruptio placentae (AP-53.08%) followed by placenta praevia (PP-38.46%) and unknown (UK-8.46%). Anaemia (90%) was the commonest maternal morbidity. A significant association found between APH type and HELLP infection (p<0.0001), PPH (p=0.028) and DIC (p<0.0001). Rate of maternal morality was 9.23% and commonest causes of mortality were renal failure and PPH (91.67% each). Most common neonatal morbidities were birth weight of <2.5 kgs (84.32%) and NICU admission (27.61%). APH type was significantly associated with birth weight (p<0.0001). Majority of neonates were born live (56.72%), 36.57% were IUDs, 6.72% were still born, and 14.18% were neonatal deaths. APH type was significantly associated with live births and IUDs, (p<0.0001).

Conclusions: APH is still a leading cause of maternal morbidity and mortality. Most of the patients were booked at other centres and were presented late with complications at the time of admission. Both these factors have contributed significantly to the incidence of APH as well as maternal and perinatal morbidity and mortality.


Keywords


APH, Mortality, Morbidity, AP, PP, Anaemia

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References


Bhide A, Thilaganathan B. Recent advances in the management of placenta previa. Curr Opin Obstet Gynecol. 2004;16(6):447-51.

Calleja-Agius J, Custo R, Brincat MP, Calleja N. Placental abruption and placenta praevia. Eur Clin Obstet Gynaecol. 2006;2:121-7.

Wasnik SK, Naiknaware SV. Antepartum haemorrhage: causes and its effects on mother and child: an evaluation. Obstet Gynecol Int J. 2015;3(1):255-8.

Dutta DC. Antepartum hemorrhage. In text book of obstetrics. 6th ed. Kolkatta: New central book agency. 2006;243-6.

Tikkanen M. Etiology, clinical manifestations, and prediction of placental abruption. Acta Obstet Gynecol Scand. 2010;89:732-40.

Sinha P, Kuruba N. Antepartum haemorrhage: an update. J Obstet Gynaecol. 2008;28(4):377-81.

Walfish M, Neuman A, Wlody D. Maternal haemorrhage. Br J Anaesth. 2009;103(1):i47-56.

Lakshmipriya K, Vijayalakshmi V, Padmanaban S. A study of maternal and fetal outcome in Antepartum haemorrhage. International Journal of Clinical Obstetrics and Gynaecology 2019; 3(1): 96-99.

Kedar K, Uikey P, Pawar A, Choudhary A. Maternal and fetal outcome in antepartum haemorrhage: a study at tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2016;5:1386-93.

Sharmila G, Prasanna. Maternal and perinatal outcome in antepartum hemorrhage. IAIM. 2016; 3(9):148-60.

Kwawukume EY. Antepartum haemorrhage. Comprehensive Obstetric in the Tropics, first edition. Edited by Kwawukume EY, Emuveyan EE. Asante and Hittscher printing press limited (Dansoman). 2002;140-50.

Bako B, Audu BM, Chama CM, Kyari O, Idrissa A. A 8 year clinical review of antepartum hemorrhage 1999-2006. BOMJ. 2008;5(2):14-21.

Adegbola RO, Okunowo AA. Pattern of antepartum hemorrhage at the Lagos teaching hospital, Lagos, Nigeria. African journals online, 2009;56(1).

Jain S, Jain N, Dahiya P, Rohilla S, Malik R. A prospective study of maternal outcome in antepartum haemorrhage in tertiary care center in northern India. Int J Reprod Contracept Obstet Gynecol. 2016;5:29-34.

Arora R, Devi U, Majumdar R. Perinatal morbidity and mortality in Antepartum haemorrhage. J Obstet Gynecol India. 2001;51(30):102-4.

Kulkarni AR, Shirsath AS. Study of antepartum hemorrhage and its maternal and perinatal outcome at a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2021;10:2210-4.

Yadav MC, Mehta K, Choudhary V. A Study of Antepartum Hemorrhage and Its Maternal and Perinatal Outcome at Tertiary Care Hospital in Western Rajasthan. JMSCR. 2019;7(9):80-5.

Raj S, Kaur A, Grover S, Kumar A. Maternal and Perinatal Outcome in Antepartum Hemorrhage- A Clinical Study. J Adv Med Dent Scie Res. 2018;6(8):53-8.

Tyagi P, Yadav N, Sinha P, Gupta U. Study of antepartum haemorrhage and its maternal and perinatal outcome. Int J Reprod Contracept Obstet Gynecol. 2016;5:3972-7.

Khouri A, Sultan MG. Previous Caesarean Section and the Rising Incidence of Placenta Praevia and Placenta Accreta. J Obstetr Gynaecol. 1994;14:14-6.

Patvekar M, Thawal Y, Kolate D, Bhola A, Bhargavi N, KH PP et al. Study of etiopathology and risk factors of antepartum haemorrhage in a tertiary care center. Int J Clin Obstet Gynaecol. 2019;3(6):74-8.

Hamadameen AI. The maternal and perinatal outcome in antepartum hemorrhage: A cross-sectional study. Zanco J Med Sci. 2018;22(2):155-63.

Das S, Bhattacharyya AR. A study of risk factors and obstetric outcome of antepartum haemorrhage in a tertiary care hospital of eastern India. Panacea J Med Sci. 2020;10(3):269-75.

Rathi BA, Pawar SP. Clinical study of Maternal and perinatal outcome in antepartum haemorrhage at a tertiary care institute. Med Pulse Int J Gynaecol. 2020;16(3):39-42.

Downes KL, Grantz KL, Shenassa ED. Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review. Am J Perinatol. 2017;34(10):935-57.

Liu Cn, Yu Fb, Xu Yz. Prevalence and risk factors of severe postpartum hemorrhage: a retrospective cohort study. BMC Pregnancy Childbirth. 2021;21:332.

Rajini P, Devi VA, Singh A, Grishma P. Maternal and Perinatal Outcome in Cases of Antepartum Hemorrhage in Gandhi Hospital. J Dental Med Sci. 2016;15(6):9-11.

Chandnani K, Chavda R. Maternal and perinatal outcome in antepartum hemorrhage. Int J Clin Obstetr Gynaecol. 2019;3(1):221-5.

Samal SK, Rathod S, Rani R, Ghose S. Maternal and perinatal outcomes in cases of antepartum haemorrhage: a 3-year observational study in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2017;6:1025-9.