Perinatal Outcome and Near-miss Morbidity Between Placenta Previa Versus Abruptio Placentae

Objective: To compare perinatal outcome and near-miss morbidities between placenta previa versus abruptio placentae in patients of antepartum haemorrhage (APH). Study Design: Cross-sectional, analytical study. Place and Duration of Study: Gynaecology Unit II, Civil Hospital, Karachi, from August 2007 to July 2009. Methodology: Patients with APH diagnosed as placenta previa and abruptio placentae who delivered after 24 weeks of pregnancy were selected from labour room. Outcome measures were birth weight, neonatal intensive care admission, stillbirth, perinatal mortality rates, near-miss, surgical intensive care admission, postpartum haemorrhage, hysterectomy, massive transfusion, renal failure, coagulopathy and maternal death. Stillbirth was defined as a fetus weighing >= 500 gm showing no sign of life after birth. Near-miss was defined as severe organ dysfunction which if not treated appropriately, could result in death. Descriptive statistics were calculated and chi-square was applied with significance level < 0.05. Results: Stillbirths and perinatal mortality rates were significantly higher in abruptio placentae, 52.97% versus 18.18% and 534/1000 versus 230/1000 (p < 0.01). Near-miss cases were also significantly higher in abruptio placentae, 22.27% verus 11.18% (p < 0.01). Hypovolemic shock and coagulation failure were also significantly higher in abruptio placentae (p < 0.05). Conclusion: Abruptio placentae carry significantly higher perinatal mortality and near-miss morbidity than placenta previa.