Identifying the risk factors of antepartum haemorrhage and to evaluate the feto maternal outcome in antepartum haemorrhage cases (original) (raw)
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Study of obstetric outcome in antepartum haemorrhage
The aim of the present study was to study the demographic profile, type of antepartum haemorrhage, maternal and perinatal complications in cases of antepartum haemorrhage and to formulate preventive guidelines so as to reduce maternal and perinatal complications in cases of antepartum haemorrhage. This retrospective study period extends from 1 st May 2013 to 30 th June 2013. Fifty-seven diagnosed cases of antepartum haemorrhage were included in the study. The data was collected on a predesigned proforma and percentage analysis was done. Out of total 57 diagnosed cases of antepartum haemorrhage, multiparty was the major risk factor observed in present study. Placenta previa was the commonest type of antepartum haemorrhage, abruptio placentae being the second major type. In spite of tertiary care, there was 1 maternal death and high perinatal mortality (21.1%). The present study indicates that uncorrected anaemia (71.9%) is still common in India contributing to increased maternal mortality and also necessitating high requirement of blood transfusion (66.7%). Multiparty (61.4%), previous LSCS (21%) were the major etiological factors contributing to antepartum haemorrhage. Based on the observations made during the study, it can be concluded that antepartum haemorrhage is the major cause of maternal morbidity and perinatal mortality.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Antepartum hemorrhage (APH) is a grave obstetrical emergency. It is leading cause of maternal death. Aim of the present study was to see maternal outcome patient with APH. Methods: It was a prospective study carried out over a period of one year on 100 women admitted with the diagnosis of APH at Pt. B.D Sharma medical college, Rohtak, Haryana, India, a tertiary care center. 100 patients with antenatal hemorrhage were studied prospectively. History was taken regarding age, hemoglobin status, blood unit given, ultrasound done to note type of placenta, distance of placenta from Os noted, third stage and delayed complication recorded. Results: 40.7% patients of placenta previa had immediate LSCS. 44.4% patients of placenta previa delayed LSCS was done after expectant management. 61.76% of patients of abruptio placentae had immediate vaginal delivery. 16% had atonic postpartum haemorrhage as third stage complication. One patient lynch sutures were applied. In 2 cases bilateral internal iliac artery ligation was done. In 3 cases bilateral uterine artery ligation done to control PPH. 71% patients of APH had postpartum anemia as delayed complication. Conclusions: The single most important factor in reducing maternal mortality has been the increase use of caesarean delivery in cases of abruptio placentae. Anemia is the most common cause of maternal morbidity (80%) associated with APH in the present study.
Study of antepartum haemorrhage and its maternal and perinatal outcome
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
INTRODUCTION Antepartum haemorrhage (APH) is defined as bleeding from or into the genital tract after the period of viability until delivery of fetus. The World Health Authority defines antepartum haemorrhage as bleeding after 28th week of pregnancy. 1 On an average 2 to 5% of all pregnancies are complicated by antepartum haemorrhage. 1,2 Obstetric haemorrhage accounts for 22-25% of maternal mortality and amongst these antepartum haemorrhage is the most common cause of morbidity and mortality accounting for half of these deaths. 2 Etiology includes placenta previa, abruptio placentae, local causes, systemic causes and idiopathic origin. Placenta previa refers to a placenta situated partially or completely within the lower uterine segment. Incidence is 4-5 per 1000 pregnancies. 2,3 Placenta previa is classified as: 1 Type 1 or Low lying: Encroaches lower uterine segment but does not reach internal os
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Antepartum haemorrhage (APH) is an emergency obstetrical condition that accounts for 2-5% of pregnancies and contributes to high level of maternal and perinatal mortality and morbidity. The present study was undertaken to assess the incidence of APH and to determine the maternal and fetal outcome in women with APH.Methods: This study was conducted in 130 women diagnosed with APH (gestational age ≥28 weeks) admitted in the department of obstetrics and gynaecology, at tertiary care hospital in central India over a period of 18 months from January 2020 to June 2021.Results: The overall incidence of APH was 1.09% and majority of them had abruptio placentae (AP-53.08%) followed by placenta praevia (PP-38.46%) and unknown (UK-8.46%). Anaemia (90%) was the commonest maternal morbidity. A significant association found between APH type and HELLP infection (p<0.0001), PPH (p=0.028) and DIC (p<0.0001). Rate of maternal morality was 9.23% and commonest causes of mortality were...
Maternal and fetal outcome in antepartum haemorrhage: a study at tertiary care hospital
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Antepartum hemorrhage (APH) complicates about 2-5% of pregnancies. Maternal and perinatal morbidity and mortality associated with APH can be reduced significantly by aggressive expectant management. The objective was to study the maternal and fetal outcome in APH and to assess the importance of early diagnosis and treatment Methods: This prospective study was conducted in the department of OBGY in IGGMC Nagpur from Dec 2013 to Nov.15. 131 cases of APH with gestational age >28 weeks were included. They were distributed according to type of APH into Abruptio Placentae (AP), Placenta Previa (PP) and Unclassified Haemorrhage (UH). Causes of APH were noted and maternal as well as perinatal outcome observed. Results: Out of 131, 51.91% was AP followed by PP (45.80%) and 2.29% of UH. Maximum patients belonged to 25 to 29 years age group (40.46%), which was statistically significant (p value 0.023). Maximum no. of patients who presented with APH was of more than 36 weeks of gestational age which was statistically significant (p value 0.0001). 52.94% had PIH as a causative factor of abruption while 41.67% had history of previous LSCS for PP. Anaemia was most common complication in APH followed by PPH. One patient died of renal failure in AP. Neonatal jaundice was the most common complication amongst the neonate followed by prematurity. Conclusions: Prevalence of APH was 2% with AP being most common cause followed by PP. Though maternal morbidity is reduced with modern management of APH, but timely diagnosis and intervention is necessary.
Journal of Medical Science And clinical Research
Background: Antepartum hemorrhage is an obstetric emergency contributing to a significant amount of perinatal & maternal morbidity and mortality. The main causes of APH are placenta previa, abruptio placentae, indeterminate cause or local causes of genital tract. APH complications can be fetal as well as maternal. The maternal complications are malpresentation, premature labor, postpartum hemorrhage, sepsis, shock and retained placenta. Various fetal complications are prematurity, low birth weight, intrauterine death, congenital malformation and birth asphyxia. Objective: To study maternal and perinatal outcome in patients of APH at a tertiary care referral hospital in Western Rajasthan. Material and Methods: This was a retrospective observational study conducted over a period of one year. A total of 112 cases of APH were studied. The diagnosis of all cases was made on the basis of history, clinical examination and ultrasonography. All the cases of hemorrhage were grouped as: Placenta Previa, Abruptio Placenta or other causes. Results: Out of 8623 deliveries, 112 had APH, incidence being 1.29%. Maximum number of cases about 86(76.8%) were of placenta previa followed by abruptio placentae in 23 cases (20.5%) and the least was unclassified hemorrhage 3(2.7%). The incidence of APH was highest 43.8% in the age group 25-29 years. Anemia was the most common complication (51.7%) in APH patients. Neonatal jaundice was the most common complication (26.8%) amongst the neonate of APH. Conclusion: High incidences of APH are associated with iron deficiency anemia and lack of awareness in India. Maternal and perinatal morbidity and mortality could be prevented by early regular antenatal care, improved nutritional status, better antenatal services, increased awareness, and timely caesarean section.
Characteristics of patients of ante-partum hemorrhage at a tertiary care centre
Innovative publication, 2016
Introduction: Antepartumhaemorrhage (APH) defined as bleeding from or into the genital tract after 24 weeks of gestation but before the birth of baby. The causes of APH are placenta previa, abruption placentae, local causes and vasa previa. Aims and Objectives: To study the demographic profile and maternal and perinatal outcome in antepartum haemorrhage. Material and Methods: It is a retrospective study done at a tertiary care centre in Haryana over a period of seven months. Case files of 140 patients of antepartum haemorrhage were studied for various parameters and analyzed. Results: Total deliveries were 6227 during the study period, out of which abruption placentae cases were 51.43% and placenta previa were 48.57%. Three maternal death were reported due to abruption placentae and one was due to placenta previa. Perinatal mortality was 68.96% due to abruptio placentae and 16.96% was due to placenta praevia. Conclusion: In antepartum haemorrhage, both mother and foetus are at risk. Proper antenatal care, early diagnosis, early referral and timely management can improve the maternal and perinatal outcome.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2022
Background: Antepartum haemorrhage (APH) is described as bleeding from or into the genital tract which occurs after 24 weeks of pregnancy and before prior to birth of infant. As per RCOG Guidelines in India, viable period is 28 weeks. APH is one of the leading causes of maternal mortality mostly in perinatal period worldwide and almost 3-5% of all the pregnancies are complicated because of it. Objectives of the study were to analyse incidence, risk factors of APH and to study the outcomes, the mode of delivery, perinatal mortality and also maternal mortality in APH.Methods: A retrospective study conducted on patients who were admitted to TMMC and RC with complaints of bleeding per vagina after 28 weeks of pregnancy over a period of 1 year (December 2019-2020).Results: A total of 100 patients with APH out of 1440 deliveries were noted which calculated the incidence to 6.9%. Out of all APH cases, the patients having placenta praevia made 65% of the total cases, abruptio placenta were ...
Antepartum hemorrhage (APH) is a grave obstetrical emergency. It is leading cause of perinatal death . Aims of the present study were to study perinatal outcome in patients with antepartum hemorrhage. It is a prospective study carried out over a period of one year (2011-12) on 100 women admitted with the diagnosis of APH at Pt. B.D Sharma medical college, Rohtak, Haryana, India, a tertiary care center. Perinatal outcome recorded according to gestational age, Apgar score, mode of delivery, weight of baby, neonatal mortality and morbidity. Perinatal mortality was higher in vaginally delivered patients (71.4%) in comparison to patients who had caesarean section (53.8%) in abruptio placentae cases. Perinatal mortality decreases with increasing baby weight in placenta previa cases, while perinatal mortality is even high in babies more than 2500 gm in abruptio placentae cases. 79% babies had low apgar score and perinatal mortality in this group was 50.6% while 21% babies with higher Apgar >7 had mortality of 4.7% only.
BACKGROUND: An Antepartum hemorrhage is defined as bleeding into or from the genital tract from 24 weeks gestation and onwards, before the delivery of the baby. It is still a grave obstetric emergency contributing to a significant amount of maternal and perinatal morbidity and mortality in our country. Hemorrhage was a direct cause of maternal death in about 30% of cases. Although APH cannot be prevented ,maternal and perinatal morbidity and mortality associated with APH can be reduced significantly by prompt diagnosis and aggressive management. STUDY DESIGN: It is a prospective observational study. PLACE OF STUDY: Chengalpattu medical college and hospital. METHODOLOGY: Study involves all consenting pregnant women who presented with APH in the antenatal OPD and casualty, confirmed by clinical examination and by ultrasound, attending hospital during the study period.Through proper history taking and clinical examination and lab investigations, these patients were followed up till six weeks postpartum and complications arising in these patients and their fetuses, their incidence and perinatal outcome were evaluated during the study period. RESULTS: Among the patients , below 30 age group was more in the study. Majority of patients were Primi and second gravida. Most patients were of gestational age between 28 to 36 weeks. During presentation only 22% of women had Hb less than 6.9 gm% that too majority cases were because of abruption placenta other 78%had Hb more than 7 gm%. Hence blood transfusion rates were more in the abruption placenta group. Preeclampsia and eclampsia contributed to 36% of cases of APH. Almost 50% of patients had to be taken up for emergency LSCS due to obstetric indications.