RISK FACTORS AND MATERNAL OUTCOMES OF PLACENTAL ABRUPTION IN A TERTIARY CARE HOSPITAL IN QUETTA

Abstract

Background: Placental abruption is a life-threatening obstetric emergency and an important cause of maternal morbidity and mortality, particularly in developing countries. Identification of associated risk factors is essential for timely diagnosis, appropriate management, and improved maternal outcomes.

Objective: To determine the risk factors and maternal outcomes of placental abruption among women managed at a tertiary care hospital in Quetta.

Place and Duration of study: From March 2025 to August 2025 Gynecology and Obstetrics Department, Sandeman Provincial Hospital / Bolan Medical College / Hospital, Quetta.

Methodology: This cross-sectional analytical study was conducted at the Department of Obstetrics and Gynecology, Sandeman Provincial Hospital / Bolan Medical College / Hospital, Quetta. A total of 100 pregnant women diagnosed with placental abruption after 28 weeks of gestation were enrolled using consecutive non-probability sampling. Data regarding demographic characteristics, obstetric history, associated risk factors, and maternal outcomes were collected using a structured proforma. Statistical analysis was performed using SPSS version 26. Continuous variables were expressed as mean ± standard deviation, while categorical variables were summarized as frequencies and percentages. Associations between risk factors and maternal outcomes were analyzed using the Chi-square test, with p <0.05 considered statistically significant.

Results: The mean maternal age was 30.8 ± 5.7 years, and the mean gestational age at presentation was 35.2 ± 2.9 weeks. The most common risk factors included anemia (46%), pregnancy-induced hypertension (38%), previous cesarean section (29%), premature rupture of membranes (18%), chronic hypertension (14%), and previous placental abruption (11%). Maternal complications comprised blood transfusion (41%), postpartum hemorrhage (34%), intensive care unit admission (15%), disseminated intravascular coagulation (9%), acute kidney injury (5%), hysterectomy (4%), and maternal mortality (3%). Hypertensive disorders (p=0.012), severe anemia (p=0.021), and previous cesarean delivery (p=0.036) were significantly associated with adverse maternal outcomes.

Conclusion: Placental abruption is associated with substantial maternal morbidity. Hypertensive disorders, anemia, and previous cesarean delivery were significant predictors of adverse maternal outcomes. Strengthening antenatal surveillance, early risk identification, and prompt multidisciplinary management may reduce maternal complications and improve outcomes.