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TITLE:
Maternal Morbidity in Grade Three Abruptio Placenta in a Tertiary Care Centre
ABSTRACT:
Objective: To understand the impact of grade three abruptio placenta on maternal health and propose various methods to minimise it.
Methods: This is a retrospective observational study conducted in the department of obstetrics and gynaecology in KAMSRC, Hyderabad, Telangana, over a period of three years from 2017 to 2019. The main outcomes measured were risk factors, complications and outcome.
Results: The incidence of abruptio placenta in our centre is 0.7%. The total number of cases of grade 3 abruption were 18, out of which 14 patients had gestational hypertension or pre-eclampsia, 1 had eclampsia, 1 had trauma, 1 multiple pregnancy, and 1 polyhydramnios. 13 had intrauterine death, 2 were stillborn and one neonatal death, 2 live births admitted to NICU. The complication rate is 88% in these patients. The most common complications are postpartum anemia, postpartum hemorrhage, acute kidney injury, puerperal pyrexia, thrombocytopenia, and coagulopathy respectively.
Conclusion: Grade 3 abruption is associated with high perinatal mortality and maternal morbidity, so early diagnosis and active management to prevent complications is needed. Also prevention of anemia and early detection of gestational hypertension and pre eclampsia can reduce maternal morbidity and fetal death in utero.