Foeto-maternal outcome of abruptio placentae at a Nigerian tertiary hospital

Abstract

Abruptio placentae remain a major cause of maternal morbidity and mortality and a significant cause of perinatal loss especially in the resource poor countries like Nigeria. The objective of this study was to determine the risk factors, maternal and perinatal outcomes of patients managed for abruptio placentae at the University of Abuja Teaching Hospital, (UATH), during a five-year period. A retrospective 5-year review of all cases of abruptio placentae managed at the University of Abuja Teaching Hospital between 2012 and 2016 was carried out. The patients’ case notes were retrieved from the records department of the hospital and studied for socio-demographic characteristics, parity, gestational age, clinical presentation, risk factors for abruptio placentae, foetal and maternal outcomes. Total number of deliveries during the study period was 10767. Fifty-five (0.51%) women had abruptio placentae. Age significantly affected the incidence of abruptio placenta in this study (p=0.001). Parity was not significantly associated with abruptio placenta (p=0.73). Abruptio placentae occurred more frequently amongst unbooked women (70.9%). Maternal complications were postpartum haemorrhage (16.4%), haemorrhage shock (10.9%), postpartum anaemia (acute) (21.8%), and puerperal sepsis (3.6%). There was one maternal death, giving a case fatality rate of 1.8%. Adverse foetal outcome was noted in severe cases of abruptio placentae. There were seven perinatal deaths giving a perinatal mortality rate of 127 per 1000 births. Abruptio placentae is associated with adverse maternal and foetal 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 from the complications. Early diagnosis and prompt treatment of placental abruption will significantly improve foetal and maternal outcome. Key words: Abruptio placentae, risk factors, maternal, perinatal outcomes.