Maternal And Perinatal Outcome In Antepartum Haemorrhage At KAHER, Belagavi -One Year Hospital Based Observational Study

Abstract

Introduction: Antepartum hemorrhage is a grave obstetric emergency contributing to a major amount of perinatal and maternal morbidity and mortality Objective: To study maternal and perinatal outcomes in antepartum hemorrhage. Methods: It was a observational study carried out from January 2017 to December 2017. All antenatal cases getting admitted in KAHER with a diagnosis for antepartum hemorrhage were included. Complete details of the maternal and the neonatal outcome using the proforma were collected for the analysis Results: The total numbers of cases with antepartum haemorrhage were 131. Incidence of antepartum hemorrhage was 2.4% . The total numbers of cases with placenta previa were 59 and with abruption placenta were 70. There was 1 case with antepartum hemorrhage of unknown origin and one case with a cervical polyp The incidence of placenta previa in the current study was 1.09%. 74.6% were multigravida and 25.4% were primigravidas. The most common gestational age in the present study to be diagnosed as placenta previa was between 33-37 weeks. Maximum patients were with type 4 and type 3 of placenta previa according to F.J. Browne’s classification. Most common mode of presentation was painless vaginal bleeding seen in 49.2% of the patients and 18.6% patients presented with vaginal bleeding with preterm labor. The most common risk factors with placenta previa were anemia, fetal growth restriction and history of previous LSCS. 3 patients underwent peripartum hysterectomies. 31 babies i.e. 52.5% needed NICU admission. 57.1% cases were multigravidas and 42.9% were primigravidas. 38.6% cases with abruptio placenta were registered in our hospital and 61.4% were registered outside. Maximum patients with abruption placenta were in the age group of 21 – 30 years i.e. 71.4%. 17.2% were above the age of 30 years and 11.4% were less than 20 years of age. 80% cases with abruption placenta presented with gestational age between 33- 37 weeks. revealed type (71.4%) of the abruption had the highest incidence followed by concealed type (24.2%) and mixed type (4.4%). 35 patients presented to the hospital with severe pain in abdomen associated with vaginal bleeding. The most common associated factor was pre eclampsia. 24 patients had couvelaire uterus. Peripartum hysterectomy was done for 2 patients Conclusion: The commonest cause of antepartum hemorrhage was placental abruption followed by placenta previa. The commonest mode of delivery was cesarean section. The present study indicates that uncorrected anemia is still common and contributing to increased maternal mortality and also necessitating high requirement of blood transfusion. Pre eclampsia and previous LSCS were the major etiological factors contributing to antepartum hemorrhage