Publication:

A clinical study of fetomaternal outcome in cases of abruption placentae in tribal population of North East Gujarat

Background Abruptio placentae is a serious obstetric emergency characterized by premature separation of the normally implanted placenta, leading to significant maternal and perinatal morbidity and mortality. Early identification and prompt management are essential to improve outcomes. Objectives were to evaluate the fetomaternal outcomes in patients with abruptio placentae and to analyze the association of demographic, clinical, and hematological factors with the severity of abruption and neonatal outcomes.

Methods This hospital-based observational study included 75 patients with clinically and/or ultrasonographically diagnosed abruptio placentae admitted to a tertiary care center. Maternal demographic characteristics, antenatal risk factors, clinical presentation, hematological parameters, and obstetric outcomes were analyzed. The degree of abruption was categorized into grades, and its association with maternal findings, hemoglobin levels, clinical signs, and neonatal outcomes such as birth weight, APGAR score, and fetal survival was assessed.

Results Most patients were in the 18-25-year age group (48%), and the majority presented in the preterm period (83.99%). Hypertensive disorders and anemia were the most common risk factors. Grade 1 abruption was seen in 50.67% of cases, followed by grade 2 (32%) and grade 3 (17.33%). Severe anemia, pallor, and edema were significantly associated with higher grades of abruption. Low birth weight (<2000 g) was observed in 76% of neonates, and 53.33% had APGAR scores ≤6. Live births accounted for 57.33% of cases, while fetal loss occurred in 42.67%.

Conclusions Abruptio placentae is associated with high maternal and perinatal risk, particularly in preterm pregnancies with hypertensive disorders and anemia. Early antenatal risk identification, timely referral, and prompt multidisciplinary management are crucial to improve fetomaternal outcomes.