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Background: Placental abruption is defined as the premature separation of the placenta from the uterus. It is relatively less common however; associated with considerable maternal and perinatal morbidity and mortality. Women of rural areas are particularly vulnerable to such pregnancy related complications.Objective: To determine the incidence, predictors,risk factors and assess outcomes of abruption placentae among women of rural areas.Study type,settings& duration:A descriptive cross sectional study conducted at the Department of Obstetrics and Gynecology, Shaikh Zayed Women Hospital, Larkana from February 2018 to January 2019.Methodology:A total of 4911 deliveries occurred out of which, 141 placental abruption cases were recorded which were included in the study. Pregnant women with clinical diagnosis of abruption placenta, over 28 weeks gestation characterized by painful vaginal bleeding accompanied by hypertonus uterine contractions, tender uterus ± non-reassuring fetal heart rate/ fetal distress, fetal demise, pallor and rapid breathing with hypotension (systolic BP<90mmHg) were recruited. A valid written and informed consent was taken.Results:A total of 141 cases of abruption placentae were recorded ~ frequency was 2.87%. Mean age of women was 32.12 ± 5.29 years and 58.87% women were of age group 21-30 years. Most cases presented with grade 2 & 3 degree of placental abruption. Maternal mortality was 23.4% and 40% neonatal/ fetal deaths noted while complete cure rate was 50%. Caesarean section was needed in 33.33% while postpartum hemorrhage was occurred in 25.53% cases. Factors associated with placental abruption were pre-eclampsia 29.79%, premature rupture of membranes 21.9% and low birth weight/ prematurity 24.1%.Conclusion:Placental abruption is relatively frequent in the rural women. younger age, primigravida, pregnancy induced hypertension,pre-eclampsia, premature preterm rupture of membranes, low birth weight fetus, repeated caesarean section and anemia.It results in death or complications in almost half of cases with adverse neonatal outcomes in high proportions.
Paras Soomro, Sania Pirzada, Monika Maheshwari, Najia Bhatti. (2021) Frequency, Predictors and Outcomes of Placental Abruption in Rural Sindh, Pakistan Journal of Medical Research, Volume-60, Issue-2.
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