Maternal and perinatal mortality, morbidity and risk factor evaluation in ante partum hemorrhage associated with Placenta Praevia

Kalam, Farhana; Faruq, Mohammad Omar; Chowdhury, Saleha Begum

doi:10.3329/bccj.v1i2.17197

Cited by 6 publications

(7 citation statements)

References 12 publications

(11 reference statements)

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“…Various complications observed included PPH 41%, anemia 32.3%, shock 6% and DIC in 1 patient (.75%). Our findings were consistent with Kalam F et al 20 with incidences of anemia at 38%, PPH 38%, shock 22% and DIC 2%. Almost similar incidences were found in studies conducted by Sharmila G et al 21 In present study 58.6% had blood transfusion.…”

Section: Discussionsupporting

confidence: 93%

Consequences of antepartum hemorrhage and its maternal and perinatal outcome

Jharaik

Dhiman

Verma

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Antepartum haemorrhage, a life-threatening event, is defined as bleeding per vaginum occurring after the fetus has reached the period of viability, considered to be 20 weeks in developed countries and 28 weeks in countries with low resource settings. We evaluated the consequences of antepartum haemorrhage, their maternal and perinatal outcome so as to outline the proper management of patient in order to improve both maternal and perinatal morbidity and mortality.Methods: This one-year prospective study totaled 133 cases of APH fulfilling the inclusion criteria were studied. Data was recorded on the MS excel sheet for further analysis and processing.Results: Total 6693 deliveries were conducted out of which 133 presented as APH and incidence of APH was found out to be 1.98%. Placenta previa was most common. APH was commonly associated with multigravida and most cases were in age group of 26-30 years. Most of the PP and abruption cases were admitted at 34-37 weeks and 31-33 weeks respectively. High risk factors included previous LSCS and D and C, hypertension, multiple pregnancies and malpresentations. Most of the patients underwent preterm LSCS. Most fetal complications were due to prematurity. 58.6% patients were transfused blood. Overall perinatal mortality was 20.1% and maternal mortality was zero.Conclusions: Early diagnoses, timely referrals and transfusion facilities along with trained team of doctors with well-equipped ICU facility goes a long way in avoiding APH related maternak and fetal complications.

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Section: Discussionsupporting

confidence: 93%

Consequences of antepartum hemorrhage and its maternal and perinatal outcome

Jharaik

Dhiman

Verma

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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“…The incidence of placenta previa, abruption and undetermined cases in study conducted by Sheikh F, et al [6] was 51.7%, 44.6% and 2.5% respectively and findings were similar to our study except undetermined cases. In our study the most common complications encountered was PPH which had incidence of 41%.Our findings were consistent with Kalam F, et al [7] PPH 38%…”

Section: Discussionsupporting

confidence: 91%

Prospective study to determine the causes of Antepartum Haemorrhage and resulting postpartum hemorrhage

Guleria,

Jharaik

2023

Int. J. Clin. Obstet. Gynaecol.

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Introduction: Hemorrhage is a life threatening event starting from conception till puerperium and hence obstetrics has been aptly honored to be the business of blood. Antepartum hemorrhage is defined as bleeding per vaginum occurring after the fetus has reached the period of viability but before the birth of baby. Early detection and prompt action can help us provide better maternal care and reduce the morbidity and mortality associated with the same. Materials and Methods: All cases of antepartum haemorrhage ≥ 28 weeks of gestation that were admitted in the hospital over a period of one year were evaluated. Discussion: A total of 133 patients were admitted with antepartum hemorrhage who were then evaluated. Placenta previa was the main cause i.e. 58.5% of APH in the present study. Abruptio placentae and undetermined cases were 23.3% and 18.05% respectively. In our study the most common complications encountered was PPH which had incidence of 41% Conclusion: Awareness of antenatal care during pregnancy, importance of institutional deliveries and adoption of various contraceptive methods (temporary as well as permanent) are the key factors to decrease the morbidity and mortality associated with antepartum hemorrhage and subsequent postpartum hemorrhage.

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“…Advancing maternal age increases the risk of APH due to vascular changes in the myometrium. 7,8 The mean age of patients in our study was 28±4.2 years which was similar to the study conducted by Singhal et al 2 Incidence of APH was more in multigravida (63%) in our study which was comparable to other studies. 1,2,7,8 Thus confirming the role of endometrial damage caused by repeated childbirth, a risk factor for uteroplacental bleeding in pregnancy.…”

Section: Discussionsupporting

confidence: 90%

“…7,8 The mean age of patients in our study was 28±4.2 years which was similar to the study conducted by Singhal et al 2 Incidence of APH was more in multigravida (63%) in our study which was comparable to other studies. 1,2,7,8 Thus confirming the role of endometrial damage caused by repeated childbirth, a risk factor for uteroplacental bleeding in pregnancy. 9 History of previous caesarean section was present in 3.1% of APH cases with previous admission and 7.7% of new onset APH cases which were similar to the study done by Bhatt et al 10 History of prior curettage was present in 3.1% of APH cases with previous admission and 17.3% of new onset of APH comparable to the study conducted by Prasanna et al 8 Previous caesarean section, prior abortions and dilatation and curettage increases the risk of placenta previa due to decreased vascularity noted in fibrosed tissues.…”

Section: Discussionsupporting

confidence: 90%

Antepartum hemorrhage at a tertiary care teaching hospital in Nepal

Shrestha

Shrestha²,

Singh³

et al. 2017

J Patan Acad Health Sci

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Introductions: Antepartum hemorrhage (APH) is a serious obstetrical emergency and is a leading cause of maternal and perinatal morbidity and mortality. Incidence varies from 2-5% of all deliveries. The maternal and perinatal complications of APH are anemia, postpartum hemorrhage, shock, low birth weight, intrauterine fetal death and birth asphyxia. Methods: This descriptive study was conducted at Department of Obstetrics and Gynaecology of Patan Hospital, a tertiary care teaching hospital of Patan Academy of Health Sciences (PAHS), Lalitpur, Nepal. All patients who were admitted after 22 weeks of gestation with diagnosis of antepartum hemorrhage from April 2012 to April 2016 were included. Results: The incidence of APH was 0.23% in the present study. Out of 84 patients, 39.3% were in age group of 25-29 years, 63% were multigravidae, 63% had placenta previa, 92.3% lower segment caesarean section done in new onset APH and 53.1% done in previous admitted cases of APH, 23.8% developed hypovolemic shock, 14.3% needed blood transfusion, 9.5% had postpartum hemorrhage, 1.2% had caesarean hysterectomy, 54.8% had preterm delivery, 9.5% were admitted in neonatal intensive care unit and perinatal mortality was 10.7%. Conclusions: APH is a major cause of maternal and perinatal morbidity and mortality. In our study, the most common cause of APH was placenta previa. The commonest mode of delivery was caesarean section. The major maternal complication was hypovolemic shock with consequent high blood transfusion rate and fetal complication in prematurity.

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Maternal and perinatal mortality, morbidity and risk factor evaluation in ante partum hemorrhage associated with Placenta Praevia

Abstract: Abstract

Cited by 6 publications

References 12 publications

Consequences of antepartum hemorrhage and its maternal and perinatal outcome

Consequences of antepartum hemorrhage and its maternal and perinatal outcome

Prospective study to determine the causes of Antepartum Haemorrhage and resulting postpartum hemorrhage

Antepartum hemorrhage at a tertiary care teaching hospital in Nepal

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