Risk Factors and Pregnancy Outcome of Placental Abruption at the Niger Delta University Teaching Hospital, Okolobiri, South-South Nigeria

Aim: To determine the incidence, predisposing factors, clinical presentation and perinatal and maternal outcome of patients managed for abruptio placenta.
Study Design: A retrospective review.
Place and Duration of Study: Department of Obstetrics and Gynaecology, Niger Delta University Teaching Hospital, Okolobiri between January 2009 and December 2013.
Materials and Methods: Data were collected from records of all patients presenting with abruptio placenta. Information extracted from the records included demographics, parity, gestational age, clinical presentation, risk factors for abruptio placenta, complications, and perinatal and maternal outcome. Data analysis was performed with Epi info version 6.04d. The results are presented as means with standard deviations, percentages, rates and proportions. Association between maternal age and selected obstetric and neonatal variables were assessed using the chi-square and the two-tailed Fisher exact test.
Results: A total of 40 cases of abruptio placenta were seen out of 2,736 deliveries giving an incidence of 1.46%. Age did not significantly affect the incidence of abruptio placenta in this study (p=0.13). High parity was significantly associated with abruptio placenta (p = 0.02). Unbooked status and Low socio-economic class were both significantly associated with abruptio placenta (p<0.001). Possible abdominal trauma due to traditional abdominal massage was documented in 26 (72.2%) cases and was significantly associated with abruptio placenta (p<0.01). There was one maternal death giving a case fatality rate of 2.8%. There were 19 perinatal deaths giving a perinatal mortality rate of 527.7 per 1000 births.
Conclusion: Lack of antenatal care and traditional abdominal massage during pregnancy are major predisposing factors to abruptio placenta in our environment. Perinatal mortality associated with abruption placenta is high.