Incidence of abruptio placentae and associated perinatal mortality

Abstract

OBJECTIVE: To determine the incidence of abruptio placentae and associated perinatal mortality rate at a teaching hospital. STUDY DESIGN: The clinical records of women with diagnosis of abruptio placentae were identified retrospectively by a computer search of files of all patients who delivered between April 1,1996 and June 30,1997 at our hospital. Out of 23856 registered deliveries a total of 106 cases of abruptio placentae were identified. Only women of singleton pregnancies beybnd 20 weeks' gestation who were delivered by cesarean section were included for data analysis (n:87). Maternal and neonatal records were reviewed and abstracted for maternal age, reproductive history, gestational age at delivery, neonate gender, birth weight, Apgar scores and perinatal mortality. After a detailed history and through clinical examination, women were graded before and after delivery according to classification of Page. . RESULTS: The incidence of placental abruption was 0.44% during this interval. The mean maternal age was found to be 27.10±5.32 years. The mean gestational age at delivery was found to be 33.75±4.41 weeks. Severe abruptio placentae (Grade III of Page's classification) took place in 29 cases (33.3%) while Grade II occured in 46 patients and Grade I in 12 patients (52.9%, and 13.8%, respectively). Hypertensive disorders were identified in 26 cases (29.9%), whereas Diabetes Mellitus was observed in 5 women (5.7%). Fourteen patients were diagnosed to have preterm labor(16.1%). There were 8 cases with the diagnosis of intrauterine growth retardation ( 9.2%). The overall perinatal mortality was found to be 51.7%. CONCLUSION: Abruptio placentae still remains as an important obstetric problem which is associated with a high perinatal mortality rate. (Gynecol Obstet Reprod Med 1997; 3:344-350)