Management outcomes of abruptio placentae at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.

BACKGROUND

The objective of this study is to determine incidence, risk factors and management outcomes of abruptio placentae (AP) and comparing them with cases without AP who delivered within the same period.

METHODS

A 10 year retrospective study of AP managed at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, between January 2001 and December 2010 was undertaken. Proforma was initially used for data collection before transfer to Epi-info 2008 software. Test of associations were evaluated and P < 0.05 was considered significant.

RESULTS

Sixty nine cases out of a total delivery of 8,811 were seen, giving an incidence of 0.8%. The mean age and parity of women with AP were 30.8 +/- 0.9 years and 4.1 +/- 0.6 respectively and majority (78.3%) of cases were unbooked (p = 0.0019). Grand multiparity and age = 35 years were significant risk factors ( p < 0.05). Fifty two (75.4%) cases were delivered by caesarean section (c/s) ( P = 0.0000). The sex ratio was 160 ( p = 0.0134). The overall maternal mortality ratio during the study period was 987 per 100,000 live births with AP contributing 3.8% of the maternal deaths while perinatal mortality rate was 52.2%.

CONCLUSION

A significant number of cases have high perinatal mortality. Unbooked, high parity, advanced maternal age and previous c/s scar were significant aetiological risk factors.