Predictors of foeto-maternal outcome of patients with abruptio placenta at Bugando Medical Centre, Tanzania

Abstract

Background: Abruptio placenta (AP) is one of the life-threatening obstetric complications for both the foetus and mother. We conducted this study to determine the incidence and predictors of adverse outcomes of abruptio placenta at Bugando Medical Centre (BMC) in northwest Tanzania.

Methods: This descriptive cross-sectional study was conducted from October 2012 to April 2013. Women with clinical features of abruptio placenta attending BMC were recruited. Data were collected using a structured checklist and analysed with STATA 11.

Results: A total of 3,800 deliveries occurred during study period. The incidence of AP was 2.5% (95/3800). Among patients with AP, 49 (51.6%) delivered by Caesarean section. Three (3.2%) maternal deaths occurred. These deaths were strongly associated with the presence of maternal anaemia (p<0.05), and postpartum haemorrhage (p<0.05). The foetal adverse outcomes were prematurity 78 (82.1%), foetal distress 65 (68.4%), low birth weight 46 (48.4%) and intrauterine foetal deaths 30 (31.6%). Perinatal deaths occurred in 52 (54.7 %) of the cases, and were predicted by low birth weight (p<0.001), vaginal delivery (p=0.001), birth asphyxia (p<0.001), and retroplacental clot (>700ml) (p<0.001).

Conclusion: The incidence of AP at BMC is high and characterised by poor maternal and foetal outcomes. Patients with AP should be delivered promptly to improve their survival.