Clinical Presentation and Fetomaternal Consequences of Placental Abruption: A Multi-Center Study
DOI:
https://doi.org/10.54112/bcsrj.v6i6.1825Keywords:
Placental abruption, fetomaternal, pregnancy complication, maternal morbidity, and perinatal mortalityAbstract
Placental abruption is a major obstetric morbidity described by early detachment of the placenta from the uterine wall. It is dangerous to the mother and fetus in cases of haemorrhage, fetal insufficiency, and perinatal mortality. The crucial issue in upgrading clinical management and minimizing adverse outcomes related to this condition is understanding the fetomaternal outcomes related to the condition. Objective: To evaluate the fetomaternal outcome of patients admitted with a placental abruption in a multi-centre environment. Methods: This was a cross-sectional study; the study was performed at Central Park Teaching Hospital, Lahore, from December 2022 to June 2023. Two hundred patients with ill conditions of placental abruption, and no earlier history of placental pathology development, were accepted. Departmental ultrasonographic scans and structured questionnaires were used in the collection of data. Maternal age, gestational age, kinds of abruption, heart rate of the baby, maternal complications, type of delivery, and neonatal outcome were reviewed utilising the SPSS program, version 25. Assessment of statistical significance was done using chi-square and independent t-tests. Results: The average age of the mothers was 29.4 +/- 5.7 years, and the average gestational age at which the mothers went to hospital was 34.2 +/- 3.1 weeks. Syndesmotic OGD presenting symptom was the most widespread, vaginal bleeding (78%), followed by abdominal pains (64%). Bad maternal conditions involved postpartum hemorrhage (32), hypovolemic shock (18), and emergency cesarean section (41). Fetal outcomes were intrauterine fetal death (22%), low birth weight (38%), and NICU hospitalisations (45%). A statistically strong linkage was identified amid heavy abruption and poor neonatal outcomes (p < 0.01). Conclusion: There is a high fetomaternal morbidity associated with pregnancy abruption. Fast identification of obstetric emergencies and urgent obstetric treatment are important to enhance maternal and fetal survival. The burden of this obstetric emergency can be decreased by means of multi-center surveillance and prescribed management protocols.
Downloads
References
Ananth CV, Smulian JC, Vintzileos AM. The association of placental abruption with uterine rupture in the United States: a contemporary analysis. Am J Obstet Gynecol. 2005;192(6):1917-21. https://doi.org/10.1016/j.ajog.2005.02.075
Tikkanen M. Placental abruption: epidemiology, risk factors and consequences. Acta Obstet Gynecol Scand. 2011;90(2):140–9. https://doi.org/10.1111/j.1600-0412.2010.01030.x
Oyelese Y, Ananth CV. Placental abruption. Obstet Gynecol. 2006;108(4):1005-16. https://doi.org/10.1097/01.AOG.0000239439.04364.9a
Abdella TN, Sibai BM, Hays JM, Anderson GD. Relationship of hypertensive disease to abruptio placentae. Obstet Gynecol. 1984;63(3):365–70. https://doi.org/10.1097/00006250-198403000-00015
Hladunewich M, Karumanchi SA, Lafayette R. Pathophysiology of the clinical manifestations of preeclampsia. Clin J Am Soc Nephrol. 2007;2(3):543–9. https://doi.org/10.2215/CJN.03681106
Tikkanen M, Nuutila M, Hiilesmaa V, Paavonen J, Ylikorkala O. Clinical presentation and risk factors of placental abruption. Acta Obstet Gynecol Scand. 2006;85(6):700–5. https://doi.org/10.1080/00016340600626891
Nair M, Choudhury MK, Choudhury SS, Kakoty SD, Sarma UC, Webster P, et al. Association between maternal anaemia and pregnancy outcomes: a cohort study in Assam, India. BMJ Glob Health. 2016;1(1):e000026. https://doi.org/10.1136/bmjgh-2015-000026
Kramer MS, Usher RH, Pollack R, Boyd M, Usher S. Etiologic determinants of abruptio placentae. Obstet Gynecol. 1997;89(2):221–6. https://doi.org/10.1016/S0029-7844(96)00434-6
World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016. https://doi.org/10.1002/14651858.CD011774.pub2
Ananth CV, Wilcox AJ, Savitz DA, Bowes WA, Luther ER. Effect of maternal age and parity on the risk of placental abruption. Obstet Gynecol. 1996;88(4):512–6. https://doi.org/10.1016/0029-7844(96)00237-3
Pariente G, Sheiner E, Kessous R, Michael Y, Shoham-Vardi I. Placental abruption: critical analysis of risk factors and perinatal outcomes. J Matern Fetal Neonatal Med. 2011;24(5):698–702. https://doi.org/10.3109/14767058.2010.512104
Gluck O, Mizrachi Y, Bar J, et al. Placental abruption: clinical features and risk factors. Int J Gynaecol Obstet. 2017;137(1):65–70. https://doi.org/10.1002/ijgo.12187
Alsibiani SA. Placental abruption: risk factors, clinical presentation, and outcomes. J Gynecol Obstet Hum Reprod. 2021;50(3):101951. https://doi.org/10.1016/j.jogoh.2020.101951
Tikkanen M, Gissler M, Metsäranta M, Luukkaala T, Andersson S, Heinonen S. Maternal characteristics and obstetric outcomes of singleton pregnancies with placental abruption. Acta Obstet Gynecol Scand. 2013;92(4):419–26. https://doi.org/10.1111/aogs.12059
Ananth CV, Oyelese Y, Yeo L, Pradhan A, Vintzileos AM. Placental abruption in the United States, 1979 through 2001: temporal trends and potential determinants. Am J Obstet Gynecol. 2005;192(1):191–8. https://doi.org/10.1016/j.ajog.2004.06.067
Salihu HM, August EM, Pradhan A, de la Cruz C, Alio AP. Stillbirth as a risk factor for subsequent fetal loss. J Matern Fetal Neonatal Med. 2011;24(6):745–50. https://doi.org/10.3109/14767058.2010.515257
Redline RW. Placental pathology: a systematic approach with clinical correlations. Placenta. 2008;29 Suppl A:S86–91. https://doi.org/10.1016/j.placenta.2007.12.003
Oyelese Y, Ananth CV. Predicting placental abruption. Obstet Gynecol. 2004;104(5 Pt 1):1005–6. https://doi.org/10.1097/01.AOG.0000140636.00763.67
Bahar AM, Abusham A, Tanu AR, Moro B. Risk factors and pregnancy outcomes of placental abruption in Sudan. J Obstet Gynaecol Res. 2012;38(2):447–51. https://doi.org/10.1111/j.1447-0756.2011.01728.x
You WB, Chandrasekaran S, Mikhail M, Guzman ER. Predictors of emergency cesarean delivery in patients with placental abruption. J Matern Fetal Neonatal Med. 2011;24(4):485–9. https://doi.org/10.3109/14767058.2010.507832
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Noor ul Ayin, Ali Saqlain Saleem, Sharoona Fatima, Hifza Bashir, Ajwa Tariq Aziz, Aneeza Tufail
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
