Study of Coagulation Dysfunction in Abruptio Placenta

INTRODUCTION Abruptio placenta is the condition when a normally attached placenta separates prematurely from the uterine wall. It is considered to be the most common cause of intrapartum foetal and maternal morbidity and mortality. It complicates approximately 1 in 100 pregnancies with more than 2/3rd classified as severe which was based on many risk factors or predictors. The incidence appears to be increasing worldwide due to increase in prevalence of risk factors for disorder and idiopathic causes. OBJECTIVES: 1. To find out the risk factors of abruptio placentae among antenatal mothers attending Obstetrics OPD. 2. To find out the maternal and foetal outcomes of abruptio placentae. 3. To find out the incidence of DIC and other coagulopathies among the antenatal mothers. 4. To find out the association between risk factors and DIC among the antenatal mothers. MATERIALS AND METHODS: STUDY SETTING: The study was conducted in Department of Obstetrics and Gynecology, KAPV Government Medical College, Mahatma Gandhi Memorial Government Hospital, Trichy. STUDY POPULATION: The study was conducted among the Antenatal mothers diagnosed with abruption placenta and admitted in Department of Obstetrics and Gynecology, KAPV Government Medical College, Mahatma Gandhi Memorial Government Hospital, Trichy. STUDY PERIOD: The data collection for the study was done between July 2020 to July 2021. STUDY DESIGN: It was a Hospital-based Cross sectional Analytical Study Design. SAMPLE SIZE & SAMPLING DESIGN: All Antenatal mothers diagnosed with abruption placenta and admitted in Department of Obstetrics and Gynecology, KAPV Government Medical College, Mahatma Gandhi Memorial Government Hospital, Trichy during the study period were considered for the study. Universal sampling design was followed and the sample size was 106. INCLUSION CRITERIA: All Antenatal mothers with singleton pregnancy ≥ 28 weeks of gestation. EXCLUSION CRITERIA: 1. Twin pregnancy. 2. Placenta previa. 3. Pregnant mothers presenting with bleeding P/V < 28 weeks of gestation. 4. Fibroid uterus. 5. Pregnant mothers with medical disorders such as heart disease and diabetes mellitus. 6. Genital tract trauma. 7. Lesions of genital tract (cervical polyp, CA Cervix, varicose vein). CONCLUSION: Placental abruption is one amongst the main life-threatening complications during pregnancy. Numerous risk factors are recognized; however, its incidence is usually unpredictable. Adequate antepartum care, early identification of risk factors will facilitate to some extent. Treatment in the main depends on the gestational age and severity of abruption. Timely identification and management ideally in an exceedingly tertiary care centre, applicable use of blood and blood products will considerably reduce maternal morbidity and mortality. Placental abruption increases the risk of life-threatening disseminated intravascular coagulopathy. Special emphasis must be put forth on Intensive care facilities for the treatment and care of these patients. Multidisciplinary treatment and prevention models must be encouraged to alleviate the maternal as well as foetal complications. Exceptional awareness must be given to the mothers attending ANC clinics regarding danger signs of pregnancy, high risk factors and complications with respect to abruption placentae and coagulopathies. Randomised controlled trials of appropriate power are mandatory to evaluate interventions (for example diet, vitamin supplements and antithrombotic therapy) to prevent placental abruption.Studies are vital to define the optimal timing of delivery in women with any risk factors