Foeto-Maternal Outcomes of Antepartum Haemorrhage in A Tertiary Care Centre: A Cross- Sectional Study
Keywords:
Fetal outcomes, Maternal outcomes, Obstretic complications, Placental pathologiesAbstract
Background: Antepartum hemorrhage (APH), defined as bleeding from the genital tract after 28 weeks of gestation and before delivery, remains a significant cause of maternal and perinatal morbidity and mortality, especially in low-resource settings like India. Despite improvements in prenatal care, APH continues to pose major challenges due to late diagnosis and limited access to emergency obstetric services.
Objectives: To evaluate maternal and fetal outcomes associated with APH beyond 28 weeks of gestation and identify key risk factors contributing to adverse events.
Methods: This retrospective cross-sectional study was conducted at a tertiary care hospital from March 2023 to March 2025. A total of 45 patient records with APH were analyzed. Data on maternal demographics, antenatal history, comorbidities, delivery outcomes, and neonatal status were extracted. Descriptive statistics were used to summarize findings using STATA 14.0.
Results: The mean maternal age was 26 ± 5 years. Most women were primiparous (86.7%) and unbooked for antenatal care (91.1%). Common comorbidities included gestational hypertension (55.6%), pre-eclampsia (53.3%), and anemia (42.2%). Emergency cesarean section was performed in 71.1% of cases, with 57.8% delivering preterm. Major maternal complications included shock and sepsis (57.8%), postpartum hemorrhage (48.9%), and disseminated intravascular coagulation (48.9%). The maternal mortality rate was 51.1%. Placental causes such as vasa previa (60%), abruptio placentae (51.1%), placenta accreta spectrum (48.9%), and placenta previa (44.4%) were the predominant risk factors. Neonatal complications included low birth weight (64.4%), NICU admissions (44.4%), and intrauterine deaths (28.9%). APGAR scores were <3 in 90% of newborns at 1 minute but improved at 5 minutes in 68.9%.
Conclusion: APH remains a life-threatening obstetric emergency with high maternal and perinatal complication rates. Improving antenatal registration, early detection of placental abnormalities, and management of hypertensive disorders are vital. Strengthening emergency obstetric and neonatal care services is essential to reducing the burden of APH-related mortality and morbidity.
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