Antepartum hemorrhage: A retrospective analysis from a northern nigerian teaching hospital

Abstract

Background:Antepartum hemorrhage (APH) contributes significantly to maternal and perinatal morbidity and mortality globally, particularly in the developing world like ours. Prevention, early detection, and prompt management cannot be overemphasized to significantly reduce the morbidity and mortality associated with this condition.Objectives:The study is aimed at determining the prevalence, etiology, sociodemographic characteristics, and the fetomaternal outcome of pregnancies complicated by APH in Aminu Kano Teaching Hospital, Kano.Materials and Methods:A 5 years retrospective study of all pregnancies complicated by APH at Aminu Kano Teaching Hospital, Kano, Nigeria, between January 1, 2009, and December 31, 2013, was conducted.Results:A total of 224 cases of APH were recorded out of the 18,273 cases admitted for delivery during the study period, giving an institutional prevalence rate of 1.2%. Two hundred and eighteen folders were retrieved and analyzed giving a retrieval rate of 97.3%. The mean gestational age at presentation was 35.3 ± 2 weeks and the most common causes were abruptio placenta and placenta previa constituting 68.3% and 30.0%, respectively. Sociodemographic characteristics associated with the occurrence of APH included age, booking status, parity, and socioeconomic status. The peak prevalence of APH was observed in the 35–39 year age group accounting for 33.0%. There were 123 live births and 92 stillbirths. The cesarean section rate was 53.5%. Major complications were intrauterine fetal deaths in 42.8%, postpartum hemorrhage in 24.2% of cases, and anemia necessitating blood transfusion in 61.5%. There were three maternal deaths all due to abruptio placentae during the study period giving a case specific fatality rate of 2%.Conclusion:The prevalence of APH in our setting is high. The major causes were abruptio placenta and placenta previa. The major fetal complication was intrauterine fetal death, and the major maternal complications were postpartum hemorrhage and anemia with consequent high blood transfusion rate. Early detection, provision of antenatal care, and emergency obstetric care services can reduce the negative effects of APH.

Maternal Outcome of Cases of Placenta Previa with and without Morbidly Adherent Placenta at King Abdul-Aziz University Hospital, Saudi Arabia

“…Out of these cases, placenta Previa was the leading cause constituting 76.8% of antepartum hemorrhage cases (16/1000 live births). Some studies agreed with our finding and in others, placental abruption was the leading cause [5]. The incidence of placenta Previa in our study was much higher than reported before.…”

Perinatal outcomes in pregnant patients presenting with antepartum hemorrhage: Our experiences at a teaching hospital in Central Punjab.

“…Thus early cesarean section was found to decrease the mortality in our study. 11,12 Another study from Peshawar in 2016 by Gul et al 13 reported the mean age of 29 ± 6.06 years.…”

Exploring maternal and health professional beliefs about the factors that affect whether women in Saudi Arabia attend antenatal care clinic appointments

“…However, these early signs often go unidentified due to lack of care, leading to obstetric hemorrhage accounting for 25-30% of all maternal deaths (Walfish et al, 2009, Say et al, 2014, Takai et al, 2017 . Likewise, early identification of pre-eclampsia, which is the second leading cause of maternal death (Say et al, 2014), can enable treatment (Bezerra Maia et al, 2012).…”