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Maternal and Fetal Outcome in Antepartum Haemorrhage - A Prospective Study at Tertiary Care Hospital

Bibekananda Das, Kajal Kumar Patra, Biplab Ray.




Abstract
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Background: Antepartum haemorrhage (APH) has always been one of the most feared complications in obstetrics. Antepartum haemorrhage is a grave obstetric emergency contributing to a significant amount of maternal and perinatal morbidity and mortality in our country. Haemorrhage was a direct cause of maternal death in about 30% of cases. APH complicates about 2-5% of all the pregnancies with the incidence of placenta praevia (PP) about 0.33% to 0.55% and incidence of abruptio placenta (AP) about 0.5-1%. The maternal complications in patients with APH are malpresentation, premature labour, postpartum haemorrhage (PPH), sepsis, shock and retained placenta. Methods: This study was a Prospective study, conducted in the Department of Obstetrics & Gynaecology of Burdwan Medical College and Hospital, Burdwan, West Bengal from February 2018 to July 2019 after getting approval from the Institutional Ethical Committee. 100 patients who presented at emergency OPD with APH were included in the study. The template was generated in an MS Excel sheet and analysis was done on EPI INFO software. Results: Incidence of antepartum haemorrhage (APH) is 2.35% during the study period among 4256 cases studied. The incidence rate of placenta previa, abruptio placentae and undetermined causes of APH in this study was 1.17%, 0.94% and 0.23%. The majority of the cases (62%) were in the age group between 20-29 years and the least (11%) were found greater than 29 years age group. Bleeding (80%) was a common presentation in PP. Pain abdomen and bleeding per vagina (45%) was a common presentation with abruption placentae. most of the patients (89 %) were anaemic at the time of admission. The majority of anaemic patients (49%) had blood haemoglobin levels 7- 7.9gm. 50% of placenta previa patients had Hb % level 7-7.9 Conclusions: Antepartum Haemorrhage cannot be reliable be predicted. All women presenting with APH should be assessed to establish whether urgent intervention is necessary to manage fetal compromise. Though maternal morbidity is reduced with modern management of APH, timely diagnosis and intervention are necessary.

Key words: Maternal, fetal outcome, antepartum haemorrhage






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