yemenjmedYemen Journal of MedicinecoVolume 2 Issue 2 MultidisciplinaryEnglishMay-August 2023NNY20230928ArticleAbruptio placenta and pregnancy outcome at Al-Sadka teaching hospital, Aden, YemenEnglishY8794Rehab Ahmed OmerBamhdi1EnglishNFatimaGamal-Aleil1EnglishY10.32677/yjm.v2i2.4196Background: Placental abruption is a serious obstetric complication with many potential adverse outcomes for both mother and fetus. The aim of this study was to determine the clinical characteristics, risk factors and maternal and perinatal consequences of placental abruption among pregnant women, at Al-Sadka Teaching Hospital. Methods: This was a prospective descriptive study including women with placental abruption, who delivered at Al-Sadka University Hospital, Aden, Yemen, during the period from August 1, 2015, to September 31, 2016. Statistical analysis of the data was performed with (SPSS version 24). Results: The frequency of placental abruption in this study was 0.84%. The majority of women with placental abruption were in the 20-25 age group (34.3%), multiparous (51.4%), had no antenatal care (51.4%). and illiterate (37.1%). The most common clinical presentation was vaginal bleeding (82.9%), followed by tetanic uterine contractions (68.6%). The most common risk factors associated with placental abruption were preeclampsia (34.5%) and PROM (21.8%). Most of our patients (77.1%) had a vaginal delivery, while the rest had a cesarean section delivery. The most common maternal complications were postpartum hemorrhage (100%) and hemorrhagic shock (27.5%). Perinatal death was more commonly associated with preeclampsia (55.0%), severe placental abruption (95%), and preterm birth (70%). On the other hand, perinatal death was reported in 28.6% of our patients (n=20). A higher percentage of fetuses born by caesarean section died (56.3%), while 79.6% of vaginal deliveries involved live fetuses. Conclusion: The frequency of placental abruption was 0.84%. ​​ Women with AP had a higher likelihood of being illiterate, between 20 and 25 years old, multipara, and receiving inadequate antenatal care. Accordingly, we recommend raising women's awareness of the importance of antenatal care through the media (television and radio) and creating policies to encourage high-quality routine prenatal care for all pregnant women by policymakers, particularly the Ministry of Public Health.EnglishAbruptio placenta, High risk, Maternal mortality, Pregnancy outcomeshttps://yemenjmed.com/admin/abstract?id=62References1619Tikkanen M. Placental abruption: epidemiology, risk factors and consequences. Acta Obstet Gynecol Scand. 2011;90(2):140and;ndash;9. Kovo M, Schreiber L. Placental histopathology and pregnancy outcome in placental abruption. Thrombosis Update. 2021; 5:100087Rasmussen S, Irgens LM, Dalaker K. A history of placental dysfunction and risk of placental abruption. Paediatr Perinat Epidemiol. 1999;13(1):9and;ndash;21.Lydon-Rochelle M, Holt VL, Easterling TR, et al. First-birth cesarean and placental abruption or previa at second birth. Obstet Gynecol. 2001;97(5):765and;ndash;9.Sanchez SE, Pacora PN, Farfan JH, et al. Risk factors of abruptio placentae among Peruvian women. Am J Obstet Gynecol. 2006;194(1):225and;ndash;30.Delbaere I, Verstraelen H, Goetgeluk S, et al. Pregnancy outcame in primiparous of advance maternal age. Europ J Obstet Gynecol and Repro Biolog. 2007;135(1):41-46.Opara EI, Zaidi J. The interpretation and clinical application of the word and;#39;parityand;#39;: a survey. BJOG. 2007 Oct ;114(10):1295-7.Sangkomkamhang U. The effectiveness of Evidence Based Practice for Reducing Early Postpartum Hemorrhage. Khon Kaen Hospital Med J. 2008;32(2):239-248.Ajenifuja KO, Adepiti CA, Ogunniyi SO. Postpartum hemorrhage in teaching hospital in Nigeria. afr health sci 2010; 10(1):71-74Dutta DC. Antenatal care, preconception counseling and care. In: Text Book of Obstetrics Including Perinatology and Contraception. 8th ed. India: New central Book Agency;2015; 10-p106American College of Obstetricians and Gynecologists. Gestational hypertension and preeclampsia: ACOG practice bulletin, number 222. Obstet Gynecol. 2020 Jun;135(6):e237-60.American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2011 Jan;34 Suppl 1(Suppl 1):S62-9Medina TM, Hill DA. Preterm premature rupture of membranes: diagnosis and management. Am Fam Physician. 2006 Feb 15;73(4):659-64.Oyelese Y, Smulian JC. Placenta previa, placenta accreta, and vasa previa. Obstet Gynecol.2006;107(4):927and;ndash;941Hiasat MS. The impact of maternal age and parity on the cesarean section rate. JRMS. 2005;12(1):30-34 MacDorman MF, Kirmeyer SE, Wilson EC. Fetal and perinatal mortality, United States, 2006. Natl Vital Stat Rep. 2012 Aug 28;60(8):1-22Hassan AA, Abubaker MS, Radi EA, et al. Education, prenatal care, and poor perinatal outcome in Khartoum, Sudan. International Journal of Gynecology and Obstetrics. 2009;105.(1):66-67.Jurdi SR, Jayaram A, Sima AP, et al. Evaluation of a Comprehensive Delivery Room Neonatal Resuscitation and Adaptation Score (NRAS) compared to the Apgar score: a pilot study. Global Pediatric Health. 2015 Jul 31;2:2333794X15598293.Khan NY, Bawazeer S. Analysis of perinatal mortalityand;nbsp; inand;nbsp; Adenand;nbsp; Generaland;nbsp; Hospital:and;nbsp; Aand;nbsp; hospital-basedand;nbsp; studyand;nbsp; fromand;nbsp; Yemen. Yemen J Med. 2022;1(1):22-26.Fisher S. Social inequalities in maternal and perinatal mortality. New Digest. 2008;44:18-26Gillissen A, van den Akker T, Caram-Deelder C, et al. Coagulation parameters during the course of severe postpartum hemorrhage: a nationwide retrospective cohort study.and;nbsp;Blood Adv.and;nbsp;2018 Oct 09;2(19):2433-2442.Rathi M, Rathi SK, Purohit M, et al. Couvelaire uterus. BMJ Case Rep. 2014 Mar 31;2014:bcr2014204211Vincent JL, De Backer D. Circulatory shock.and;nbsp;N Engl J Med.and;nbsp;2014 Feb 06;370(6):583Ghaheh HS, Feizi A, Mousavi M, et al. Risk factors of placental abruption. J Res Med Sci. 2013 May;18(5):422-6Akadri AA, Ogunsowo KM, Odelola OI. Abruptio Placenta: A retrospective analysis in a tertiary hospital, Sagamu, Nigeria. Trop J Obstet Gynaecol 2018;35:142-6.Nilsen RM, Vollset SE, Rasmussen SA, et al. Folic acid and multivitamin supplement use and risk of placental abruption: a population-based registry study. Am. J. Epidemiol. 2008;167:867-874Hossain N, Khan N, Sultana SS, et al. Abruptio placenta and adverse pregnancy outcome. J Pak Med Assoc. 2010 Jun; 60(6):443-6.Mukherjee S, Bawa AK, Sharma S, et al. Retrospective study of risk factors and maternal and fetal outcome in patients with abruptio placentae. J Nat Sc Biol Med 2014;5:425-8.Dafallah SE, Babikir HE. Risk factors predisposing to abruptio placentae. Maternal and fetal outcome. Saudi Med J. 2004;25(9):1237-1240Saeed MU, Rana TA. Fetomaternal outcome in pregnancies complicated with placental abruption. Pakistan Journal of Medical and Health Sciences. 2011;5(1):1-5.Barua S, Chakrabarty A, Samanta A, et al. Evaluation of Maternal and Fetal Outcome in Patients of Abruptio Placentae in a Tertiary Care Center, Kolkata: A Descriptive and Observational Study. Asian J Med Sci 2022; 13(8): 208-13.Rudakova IS, Shifman EM, Tikhova GP, et al. Hypertensive disorders in pregnancy as a risk factor of premature placental abruption: a systematic review and meta-analysis. Russian Journal of Anaesthesiology and Reanimatology. 2023;2:6and;ndash;14 Aktand;uuml;rk E, Emeklioğlu and;Ccedil;N, Cıngıllıoğlu B, et al. Risk factors and maternal/fetal outcomes of pregnant women with abruptio placenta: a retrospective, descriptive study. J Health Sci Med 2022; 5(6): 1535-1540 Nankali A, Malek-Khosravi SH, Zangeneh M, et al: Maternal complications associated with severe preeclampsia. The Journal of Obstetrics and Gynecology of India; 2013, 63:112-115.Saquib S, Hamza LK, AlSayed A, et al. Prevalence and its feto-maternal outcome in placental abruption: a retrospective study for 5 years from Dubai Hospital. Dubai Medical Journal. 2020;3(1):26-31. Sengodan SS, Dhanapal M. Abruptio placenta: a retrospective study on maternal and perinatal outcome. Int J Reprod Contracept Obstet Gynecol 2017;6:4389-92. Coleman J, Srofenyo EK, Ofori EK, et al. Maternal and fetal prognosis in abruptio placentae at Korle-Bu Teaching Hospital, Ghana. African Journal of Reproductive Health. 2014;18(4):115-22 Kaminsky LM, Ananth CV, Prasad V, et al. The influence of maternal cigarette smoking on placental pathology in pregnancies complicated by abruption. Am J Obstet Gynecol. 2007 Sep;197(3):275.e1-5Raymond EG, Mills JL. Placental abruption. Maternal risk factors and associated fetal conditions. Acta Obstet Gynecol Scand. 1993;72:633and;ndash;9. Cnattingius S. Maternal age modifies the effect of maternal smoking on intrauterine growth retardation but not on late fetal death and placental abruption. Am J Epidemiol. 1997;145:319and;ndash;23.Ananth CV, Savitz DA, Luther ER. Maternal cigarette smoking as a risk factor for placental abruption, placenta previa, and uterine bleeding in pregnancy. Am J Epidemiol. 1996;144:881and;ndash;9Ananth CV, Smulian JC, Vintzileos AM. Incidence of placental abruption in relation to cigarette smoking and hypertensive disorders during pregnancy: a meta-analysis of observational studies. Obstet Gynecol. 1999;93:622and;ndash;8.Bibi S, Ghaffar S, Pir MA, et al. Risk factors and clinical outcome of placental abruption: a retrospective analysis. J Pak Med Assoc. 2009 Oct;59(10):672-4Dars S, Sultana F, Akhter N. Abruptio Placentae: Risk Factors and Maternal Outcomes at Tertiary Care Hospital. Journal of Liaquat University of Medical and Health Sciences. 2013;12(3):198-202Abbasi RM, Rizwan N, Mumtaz F, et al. Maternal outcome among abruption placentae cases at a University Hospital of Sindh. JLUMHS.2008;7:106-9Budde MP, De Lange TE, Dekker GA, et al. Risk factors for placental abruption in a socio-economically disadvantaged region. The journal of maternal-fetal and;amp; neonatal medicine. 2007 Jan 1;20(9):687-93.Sharma ST. Clinical study of maternal and fetal outcome associated with abruptio placentae. International Journal of Gynaecology. 2019; 11(2): 40-44. Jabeen M, Gul F. Abruptio Placentae: Risk factors and perinatal outcome. J Postgrade Med Inst. 2004; 18: 669-76.Kapadia LD, Dhrangiya B. Study of Maternal and Perinatal Outcome in 100 Cases of Abruptio Placentae. Int J Med Res Health Sci 2017, 6(7): 84-88Tikkanen M, Gissler M, Metsand;auml;ranta M, et al. Maternal deaths in Finland: focus on placental abruption. Acta Obstet Gynecol Scand. 2009;88(10):1124-7.Jadhav K, Kadam M, Lokhande V, et al. Study of Maternal and Foetal Outcome in Abruptio Placentae.and;nbsp; International Journal of Medical Science and Clinical Invention. 2021;8(1), 5208and;ndash;5213.Arora R, Devi U, Mujamdar K. Perinatal mortality in antepartum hemorrhage. J Obstetrics and Gynecology. 2001;51(3):102-4.