Maternal and Fetal Prognosis in Abruptio Placentae at Korle-Bu Teaching Hospital, Ghana

Jerry Coleman, Emmanuel K. Srofenyo, Eric K. Ofori, Edmund K. Brakohiapa, William K. Antwi

Abstract

The study provided baseline data of abruptio placentae in Korle-Bu Teaching Hospital (KBTH), Ghana, and gave recommendations to minimize poor outcomes.  A prospective cross sectional study was conducted at the Maternity Department of the KBTH between February 2008 and January 2010. Two hundred women with diagnosis of placental abruption were studied using a pretested standardized structured questionnaire. Statistical Package for Social Sciences (SPSS) version 17 was used to analyse the data.  Fifteen thousand five hundred and ten (15,510) deliveries were recorded during the study period out of which 1.4% abruptio placentae cases were confirmed. The perinatal and maternal mortality rates were 65% and 2% respectively. The key risk factors identified were low socio-economic status, grandmultiparity and hypertensive disorders in pregnancy. Intrauterine foetal death, (IUFD) and maternal shock were significantly associated with coagulopathy (p= 0.001 and 0.004 respectively). Early diagnoses of placental abruption will significantly improve foetal and maternal survival. (Afr J Reprod Health 2014; 18[4]: 115-122).

 

Keywords: abruptio placentae, foetal, maternal, mortality

 

Résumé

L'étude a fourni des données de base de décollement prématuré du placenta au Centre Hospitalier Universitaire de Korle-Bu (CHUK) au Ghana, et a donné des recommandations pour minimiser les mauvais résultats. Une étude transversale prospective a été menée au Département de la maternité de CHUK entre le mois du février 2008 et janvier 2010. Deux cents femmes avec le diagnostic de décollement placentaire ont été étudiées en utilisant un questionnaire structuré pré-testé et normalisé.  Le Paquet Statistique pour les sciences économiques (PSPSE)  la version 17 a été utilisé pour analyser les données. Quinze mille cinq cent dix (15510) accouchements ont été enregistrés pendant la période d'étude dont 1,4% des cas de décollement placentaire ont été confirmés. Les taux de mortalité périnatale et maternelle étaient de 65% et 2% respectivement. Les principaux facteurs de risque identifiés sont le faible situation socio-économique, une grande multiparité et de l'hypertension pendant la grossesse. La mort intra-utérine du fœtus, (MIUF) et le choc maternel étaient significativement associés à la  coagulopathie (p = 0,001 et 0,004 respectivement). Les premiers diagnostics de décollement placentaire s’amélioreront de façon significative la survie fœtale et maternelle. (Afr J Reprod Health 2014; 18[4]: 115-122).

 

Mots clés: décollement prématuré du placenta, fœtus, maternelle, mortalité

Full Text:

PDF

References

UNICEF/UNFPA/WHO. Maternal mortality in 2010. Estimates developed by WHO, UNICEF and UNFPA. Department of Reproductive Health Research. World health organization. Geneva 2012.

Morgan K, Arulkumaran S. Antepartum haemorrhage. Current Obstetrics and Gynaecology 2003; 13: 18-87

Spinillo A., Capuzzo E., Colora L., Solerte L., Nicola S., Guaschino S. Factors associated with abruptio placentae in preterm deliveries. Acta Obstet Gynecol Scand 1994 ;73: 307-12

Omu A.E., Diejomaoh F.M.E., Racial difference in the etiology of abruptio placentae International Journal of Obstet Gynecol 1981; 19:205-210

Chang Y.L., Chang S.D., Cheng P.J. Perinatal outcome in patients with placental abruption with and without antenatal haemorrhage. International Journal of Gynecol and Obstet 2001; 75: 193-194.

Kwawukume E.Y. Ante partum Haemorrhage. In: Kwawukume EY, Emuveyan EE (Eds). Comprehensive Obstetrics in the tropics Accra: Asante and Hittscher Printing Press 2002 .pp 140-150.

Okonofua F.E., Olatunbosan O.A. Caesarean versus vaginal delivery in abruptio placentae associated with live fetuses. International journal of Gynecol and Obstetrics 1985; 23 (6): 471-474.

Thieba B., Lankoande J., Akotienga M., Kyelem C., Ouedraogo C.M. Abruptio placenta: epidemiological, clinical and prognostic aspects with respect to 177 case series. Gynecol Obstet Fertil 2003; 31(5): 42933.

Oyelese Y, Ananth CV. Placental abruption. Obstet Gynecol 2006; 108:1005–1016.

Ngeh N., Bhide A. Antepartum haemorrhage. Current Obstetrics and Gynecology 2006; 16:79-83.

Cunnigham F.G. Obstetric haemorrhage In: William obstetrics 21st edition. New York: McGraw-Hill; 2001.p.321-630.

Hurd W.W., Miodovnik M., Hertzberg V., Lavin J.P. Selection and management of abruptio placentae: a prospective study. Obstet Gynecol 1983; 61: 467 – 473

Lower T.W., Cunningham F.G. Placental abruption. Clinic Obstet Gynecol 1990; 33:406

Usui R., Matsubara S., Ohkuchi A. Fetal heart rate patterns reflecting the severity of placental abruption. Archives of Gynecology and Obstetrics 2007; 277:249.

Ananth C.V., Smulian J.C., Demissie K. Placental abruption among singleton birth in the United States: risk factor profiles 2001;153:721-728.

Karegard M., Gennser G. Incidence and recurrence rate of abruptio placentae in

Sweden .Obstet Gynecol 1986; 57:523 Dafallah S.E., Babikir H.E. Risk factors predisposing to abruptio placenta. Maternal and foetal outcome. Saudi Medical J 2004;25(9):1237-40.

Mooran N., Mangate H.L. Unexplained still birth. Saving

Babies 2003: Forth Perinatal Care Survey of South Africa compiled by MRC Research Unit for Maternal and infant Health Care Strategies. Email: matinfru@global.co.za. ISBN: 0-620-32650-6

Witlin A.G., Sibai B.M. Perinatal and Maternal outcome following abruption placentae. Hypertension in pregnancy 2001; 20 (2); 195 – 203.

Ananth C.V., Oyelese Y., Leo L. Pradham A., Vintzileos A.M. Placental abruption in the United States;1979 through 2001,temporal trends and potential determinants. Am J Obstet Gynecol. 2005;192:191-8

Devra L.D., Gottlieb M.B., Stampnitzky J.R. Reduced ratio of male to female birth in several industrial countries: A sentinel health indicator? JAMA 1998; 1020-1021.

Index Mundi. Ghana Demographics Profile 2012.

http://www.indexmundi.com/ghana/demographics_pr ofile.html. Date accessed 16/01/2013.

Morgan M.A., Berkowitz K.M., Thomas S.J. Abruptio placenta: Perinatal outcome in normotensive and hypertensive patients. Am Jour. Obstet Gynecol 1994; 170(6):1595-9.

Dahmus M.A., Sibai B.M. Blunt abdominal trauma: are there predictive factorsfor abruptio placentae or maternal and foetal distress? Am J Obstet Gynecol 1993; 169(4):1054-9.

Refbacks

  • There are currently no refbacks.