Antepartum haemorrhage (APH) has always been one of the most feared complications in obstetrics. Antepartum haemorrhage is till a grave obstetric emergency contributing to a significant amount of maternal and perinatal morbidity and mortality in our country. Haemorrhage was a direct cause of maternal death in about 30% of cases. APH complicates about 2-5% of all the pregnancies with incidence of placenta praevia (PP) about 0.33% to 0.55% and incidence of abruptio placenta (AP) about 0.5-1%. The maternal complications in patients with APH are malpresentations, premature labour, postpartum haemorrhage (PPH), sepsis, shock and retained placenta. Aim of the study 1. To study the prevalence of antepartum haemorrhage at tertiary care hospital. 2. To assess the importance of early diagnosis and treatment. 3. To study the maternal and fetal outcome in antepartum haemorrhage. 4. To study the associated risk factors contributing to maternal and fetal morbidity and mortality. Methodology: The study was conducted in Govt. RSRM Lying in Hospital, Chennai during the period of September 2016 to September 2017 after getting approval from the Institutional Ethical Committee.75 patients who presented at emergency OPD with APH were included in the study. RESULTS: In the present study it was observed that the incidence of APH was more common in multipara (64%) than in nullipara. The incidence of PP was 5 times higher in multipara than primipara. Chakraborty et al. reported that prevalence of APH was higher among multigravidas. Results of present study are consistent with study of Cotton et al. who found that 83.2% of their patients with PP were multiparous and 16.78% were nulliparous. Crenshaw et al. reported that 10% patients with PP were primi gravida. Ananth et al. showed that risk of placental abruption increased with high parity. Conclusion: All women with APH heavier than spotting and women with ongoing bleeding should be recommended hospital stay atleast until the bleeding as stopped. The pregnancy should receive consultant-led care following APH from placental abruption or unexplained APH, and serial ultrasounds for the monitoring of fetal growth are recommended.

Background: Maternal mental health is a public health concern especially during COVID pandemic. Essential regular Maternity services are affected due to lockdown and fear of its spread. COVID 19 had its psychological impact among general public and also among perinatal mothers. Psychological problems impact perinatal mothers, and are associated with increased risk to mother and the child. Objectives: To study the prevalence of depression, anxiety and stress among perinatal mothers delivering at a tertiary hospital. To compare these levels between COVID positive and negative mothers Methodology: A case control study among 150 COVID positive and 150 COVID negative antenatal and postnatal mothers in a tertiary hospital. Interview schedule including DASS-21 was administered to assess the levels of depression, anxiety and stress among them. Grades of depression, anxiety and stress were correlated with each other and compared with age and pregnancy status of mothers both among cases and controls. Results: Proportion of some grade of depression 96 (64.0%) among COVID cases was lesser 107(71.3%) than that of controls. Anxiety prevalence was slightly higher among cases 81(54.0%) than compared to controls 78 (52.0%). Prevalence of stress among cases 29(19.3%) and controls 28 (18.7) were similar. Mean depression scores among cases were 10.05±5.10 was significantly lesser that of controls which is 11.44±4.92.There was no association between psychological problems with age and pregnancy status both in cases and controls. There was a significant positive correlation between the scores of depression, anxiety and stress both among cases and controls. Conclusions: COVID pandemic has a significant psychological impact on all pregnant mothers irrespective of their COVID status. This emphasises the need for prompt and early assessment and management of maternal mental health among all pregnant mothers during COVID pandemic.