DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20204811

Antepartum hemorrhage and its fetomaternal outcome: a retrospective study

Saloni K. Gandhi, Ayushi P. Vamja, Kishor P. Chauhan

Abstract


Background: Antepartum hemorrhage (APH) is defined as any bleeding from or into the genital tract after the period of viability and before the delivery of the baby. Aim of the research was to study the fetomaternal outcome in patients with APH.

Methods: The present study was a retrospective observational study undertaken in Obstetrics and Gynaecology department of Dhiraj General Hospital, during a period of 1.5 years from November 2018 to May 2020 in 84 cases of antepartum hemorrhage. Only patients with APH >28 weeks gestational age and willing to participate in study were included. Open STAT statistical software has been used to analyse the data in this study.

Results: The incidence of antepartum hemorrhage was 2.86%. Maximum patients of APH lie between the age group of 26-34 years. In abruptio placenta (AP) 65% and in placenta previa (PP) 77.2% of the patients were multiparous. APH presents mostly between 34-36 weeks. Around 90% patients of APH required blood transfusion. APH overall shows increased rate of cesarean sections upto 62%. Around 9.5% patients went into shock, 4.7% had disseminated intravascular coagulation (DIC), 3.5% postpartum hemorrhage (PPH) and 8.3% had wound gap and peurperial pyrexia. 23.8% babies had asphyxia of which 60% were contributed to PP and 40% were in AP group. Respiratory distress syndrome was in 7.1% babies of which both groups equally contributed. Septicemia was seen in 13% and jaundice in 29.8%.

Conclusions: Higher rates of neonatal intensive care unit (NICU) admission and stay were seen with these complications. This study showed 20.2% perinatal deaths as outcome of APH and 14.2% still births.

 


Keywords


Antepartum hemorrhage, Fetomaternal outcome, Placenta previa, Abruptio placenta

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References


Ananth CV, Smulian JC, Vintzileos AM. Incidence of placental abruption in relation to cigarette smoking and hypertensive disorders during pregnancy: A meta-analysis of observational studies. Obstet Gynecol. 1999;93:622-8.

Cunningham F, Leveno K, Bloom S, Hauth J, Gilstrap L, Rouse D, et al. Obstetrical haemorrhage. Williams Obstetrics. 23rd Edition, New York, McGraw Hill Professionals. 2009.

Park K. Maternal and child health. In: Park’s textbook of preventive and social medicine. 17th edition. Banarasi Das Bhanot ’Jabalpur. 2000.

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.

Maurya A, Arya S. Study of antepartum hemorrhage and its maternal and fetal outcome. Int J Sci Res Pub. 2014;4(2):1-8.

Adekanle D, Adeyemi A, Fadero F. Ante-partum hemorrhage and pregnancy outcome in Lautech Teaching Hospital, southwestern Nigeria. J Med Medical Sci. 2011;2(12):1243-7.

Cotton DB, Read JA, Paul RH, Quilligan EJ. The conservative aggressive management of placenta previa. Am J Obstet Gynecol. 1980;164:687-95.

Bhandiwad A, Bhandiwad AA. A study of maternal and fetal outcome in Antepartum haemorrhage. J Evid Based Med Healthc. 2014;1(6):406-27.

Chakraborty B, De KC. Evaluation of third trimester bleeding with reference to maternal and perinatal outcome. J Obstet Gynecol India. 1993;42:166-71.

Sarwar I, Abbasi AN, Islam A. Abruptio placenta and its complication at Ayub teaching hospital Abbottabad. J Ayub Med Coll Abbottabad. 2006;127-31.

Crenshaw C, Jones DE, Parker RT. Placenta previa: a survey of twenty years experience with improved perinatal survival by expectant therapy and cesarean delivery. Obstet Gvnecol Surv. 1973;28(7):461-70.

William MA, Mittendorf R. Increasing maternal age, a determinant for placenta previa. More important than increasing parity PJ Reprod Med. 1993;38:425-8.

Dutta DC. Antepartum hemorrhage. In: Hiralal Konar, editor. Textbook of obstetrics. 6th edition. New Central Book Agency, Calcutta. 2004;243-61.