The maternal and perinatal outcome in antepartum hemorrhage: A cross-sectional study
Keywords:Antepartum hemorrhage, abruption placentae, maternal and perinatal outcome, placenta previa
Background and Objective: Antepartum hemorrhage is one of the major causes of obstetric hemorrhage and contributes to significant maternal and perinatal morbidity and mortality especially in developing countries with low resources and facilities. This study aimed to determine the incidence, to estimate maternal and perinatal outcome in relation to the types of antepartum hemorrhage, and to find out factors affecting the perinatal outcome.
Methods: This cross-sectional study was carried out from February 1st to August 1st, 2016, at the Maternity Teaching Hospital, Erbil city, Kurdistan region, Iraq. The study included 343 pregnant ladies presented with antepartum hemorrhage after 28 weeks gestation.
Results: The incidence of antepartum hemorrhagein our study was 2.34%. Placenta previa was the commonest type of antepartum hemorrhage 58%, followed by abruption placenta 36.7%. Placenta previa was most commonly occurred in women with previous caesarean scar (91%) and those with previous curettage (77%), while abruptio placentae was most commonly associated with preeclampsia (72.9%), previous antepartum hemorrhage (66.7%) and parity ≥ 5 (51.2%), Most cases of placenta previa (94.4%) delivered by caesarean section while this figure was 57.1% for abruption. Perinatal mortality in our study was 23.64%. Increasing birth weight and cesarean delivery were significantly associated with lower perinatal mortality.
Conclusion: Antepartum hemorrhage was associated with high maternal and perinatal mortality and morbidity. Placenta previa most commonly developed in women with previous uterine surgeries. In contrast, abruptio placentae developed mostly in grand multiparous women and those with preeclampsia. Most perinatal deaths occurred in babies with small gestational ages(<34 weeks), low birth weight babies(< 2.5 kg), and those who delivered vaginally.
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