Maternal Outcome in Patients with Abruptio Placenta: A Comprehensive Analysis in A Tertiary Care Hospital

Abstract

Background: Abruptio placenta is a critical obstetric condition characterized by the premature detachment of the placenta from the uterine wall, leading to significant maternal and fetal risks. Despite its rarity, the condition demands prompt diagnosis and intervention due to the high morbidity and mortality associated with it. Prior research has established a link between maternal hypertension and increased risk of severe complications such as hemorrhagic shock, disseminated intravascular coagulation (DIC), and organ failure. Objective: This study aimed to analyze the maternal outcomes of patients with Abruptio placenta in a tertiary care setting, with a specific focus on the association between hypertension and maternal complications. Methods: A prospective cohort study was conducted over a three-month period at the Obstetrics and Gynecology Department of Khyber Teaching Hospital, Peshawar. A sample size of 100 patients was determined based on the anticipated frequency of cases. Inclusion criteria were patients diagnosed with Abruptio placenta during antenatal care or at admission for delivery. Comprehensive data on demographics, medical history, clinical presentation, and management strategies were collected using standardized forms. Ethical approval was obtained from the institutional review board, and informed consent was secured from all participants. The statistical analysis was performed using SPSS version 25, with a significance level set at p < 0.05. Results: The study included 105 patients with a mean age of 28.6 years; 64.8% were multiparous, and 40.0% had hypertension. Clinical presentation included vaginal bleeding (92.4%), abdominal pain (83.8%), and fetal distress (72.4%). The majority (59.0%) were diagnosed during antenatal care, while 41.0% were diagnosed at admission. Emergency Cesarean section was performed in 93.3% of cases. Blood transfusions were required for 23.8% of patients, and 28.6% presented with a low amniotic fluid index. The mean gestational age at delivery was 34.2 weeks. The analysis revealed a significant association between hypertension and the incidence of haemorrhagic shock (12 cases with hypertension, 2 without), DIC (5 cases with hypertension, 2 without), and organ failure (3 cases with hypertension, 1 without). Conclusion: The study affirms the heightened risk of severe maternal complications associated with hypertension in patients with Abruptio placenta. The high rate of emergency Cesarean sections and blood transfusions underscores the urgency and complexity of managing this condition. These findings highlight the necessity for vigilant antenatal monitoring and rapid intervention strategies in tertiary care settings.