Perinatal And Maternal Outcomes In Antepartum Haemorrhage: A Prospective Study At A Teaching Institute

Objective: To evaluate perinatal and maternal outcomes in antepartum haemorrhage (APH) cases, focusing on causes, management strategies, and their impact at a teaching institute.

Methods: A prospective cohort study was conducted at a tertiary care centre, enrolling 112 APH cases over a one-year period in SIMS Medical College from October 2023 to September 2024. Data were collected on maternal demographics, clinical presentation, management, and outcomes using a standardized proforma. Inclusion criteria included singleton pregnancies with bleeding after 28 weeks gestation. Causes (placenta previa, abruptio placentae, unclassified) were identified via ultrasonography. MRI done to exclude adherent placenta which needs multi disciplinary approach for management.  Statistical analysis involved descriptive statistics and chi-square tests for categorical variables.

Results: APH incidence was 1.15%, with abruptio placentae (46.43%), placenta previa (42.86%), and unclassified haemorrhage (10.7%) as primary causes. Maternal complications included postpartum haemorrhage (33.0%) and anaemia (40.18%); perinatal mortality was 60 per 1000 births. Caesarean delivery was required in 82.1% of placenta previa cases. Major placenta previa was associated with higher haemorrhage risk (OR 3.18, 95% CI 1.22-8.33, p=0.017).

Conclusion: APH remains a significant obstetric challenge, with placenta previa and abruptio placentae contributing to substantial morbidity. Early diagnosis via ultrasonography and aggressive management reduced adverse outcomes, though perinatal mortality remains high.