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IMPACT OF ABRUPTIO PLACENTA AMONGST THE CHILDBIRTH CASES CONDUCTED AT A TERTIARY CARE HOSPITAL OF KARACHI

. Shizra Shahnawaz, Haleema Yasmin, Shahzaib Siddiqui & Areeba Rehman


Abstract

Objective: Placental abruption (PA) is a significant obstetric complication that increases the risk of morbidity and mortality for both mother and fetus across the world. Therefore, the aim of this study was to determine the frequency, risk factors and Impact of abruptio placenta among the childbirth cases conducted at a tertiary care hospital in Karachi.

Methodology: This was a hospital based cross sectional study that was conducted at the tertiary care hospital, Jinnah Postgraduate Medical Centre, Karachi, over a 2 years period; from January 1st, 2019 to December 31st, 2020.The maternal demographic data; age, medical history (gravidity, parity, gestational week, comorbidities, trauma, multiple pregnancies), pregnancy outcomes such as mode of delivery, and maternal morbidity (acute kidney injury, postpartum hemorrhage, anemia, DIC, ICU for ventilator support, obstetric hysterectomy), maternal mortality, and fetal outcomes were documented. The mean and standard deviation was calculated for continuous variables whereas frequencies and percentages were documented for categorical variables.

Results: A total of 178 pregnant women with PA were included in the study; their mean age was 31.19±4.85 years, and their mean gravidity was 4.089±2.65. Parity showed that most of the patients 107(60.11%) had parity 2-4. The mean gestational age was 32.87±3.46 weeks. Comorbidities revealed that 132(74.2%) patients were anemic followed by 110(61.8%) cases were hypertensive. 141(79.2%) patients spontaneously delivered vaginally, while 35(19.6%) underwent assisted vaginal delivery. There were 3(1.7%) maternal deaths observed. The Fetal outcome revealed that Only 53(29.85) fetuses were alive while 125(70.2%) were dead. Eighty eight neonates were fresh stillbirth and 37(20.8%) were macerated stillbirth.

Conclusion: This study concluded that Placental abruption was associated with high incidence of maternal and fetal morbidity and mortality. Anemia was the most prevalent maternal risk factor, followed by hypertension. Additionally, pregnant women with placental abruption frequently had abdominal pain and vaginal bleeding. In addition, the majority of the fetuses were stillbirth.

Keywords: Placental abruption, low birth weight, postpartum hemorrhage, Cesarean-section

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