Feto-Maternal Outcome of Pregnancies Complicated by Abruptio Placentae in the University of Port Harcourt Teaching Hospital, Nigeria

Abstract

Background: Abruptio placentae contributes significantly to maternal and perinatal morbidity and mortality globally particularly in the developing world. The role of prevention, early detection and prompt management in reducing morbidity and mortality associated with this condition cannot be overemphasized. Objective: To determine the incidence and feto-maternal outcome of pregnancies complicated by abruptio placenta in the university of Port Harcourt teaching hospital (UPTH). Materials and Methods: This was a retrospective study involving all pregnant women who had abruptio placenta from January 1, 2014 to December 31, 2018. Data on sociodemographic characteristics, risk factors and fetal and maternal morbidity and mortality were extracted from patients’ case notes for analysis. Results: The mean age of the subjects was 31.34  3.7 years. The incidence of abruptio placenta was 0.9%. Multiparity was the most important risk factor seen in 73.8% of cases. Birth asphyxia was the major perinatal morbidity and occurred in 27.9% of babies whereas 29.5% were stillbirths. There were 21 perinatal deaths giving a perinatal mortality rate of 344 per 1000 births. The Caesarean section rate was 78.7%. Thirty-seven (60.7%) had blood transfusion, 28 cases (45.9%) had postpartum haemorrhage and 26.2% had postpartum anaemia. There was one maternal death giving a case specific fatality rate of 1.6%. Conclusion: Abruptio placentae is associated with adverse maternal and fetal outcome. Lack of antenatal care, increasing maternal age and multiparity are independently associated with abruptio placentae and this has significant impact on the fetomaternal outcome. Early diagnosis and prompt management will significantly improve fetomaternal outcome.