Prevalence of Abruptio Placentae Among Women with Preeclampsia in a Tertiary Care Institute and its Fetomaternal Outcomes

Background: Preeclampsia (PE) remains a major cause of maternal and perinatal morbidity and mortality in developing countries. Abruptio placentae (AP), premature separation of the placenta, is a serious complication associated with preeclampsia. Coexistence of both conditions exacerbates fetomaternal risk.

Objective: To determine the prevalence of abruptio placentae among preeclampsia, identify risk factors, and evaluate fetomaternal outcomes in preeclampsia with and without abruption.

Materials and Methods: This cross-sectional observational study was conducted in the Department of Obstetrics and Gynaecology, from October 2023 to September 2024. Total 200 women diagnosed with preeclampsia beyond 20 weeks of gestation were included. Data were collected regarding demographic factors, clinical parameters, biochemical profiles, mode of delivery, and fetomaternal outcomes. Diagnosis of abruption was made clinically, ultrasonographically, and confirmed by retroplacental clots at delivery. Statistical analysis was performed using SPSS v21.0, with p < 0.05 considered significant.

Results: The mean age of participants was 25.89 ± 4.98 years, with 68% aged 21–30 years. The majority were unbooked (80%) and primigravida (45.5%). Severe preeclampsia was present in 49% of cases. The prevalence of abruptio placentae in preeclampsia was 19%. Significant risk factors included high systolic BP (>160 mmHg), severe proteinuria (≥2+), thrombocytopenia (<1 lakh/µL), and deranged liver and renal functions. Among abruption cases, maternal complications occurred in 53.5%, including postpartum hemorrhage (18.6%), eclampsia (15.8%), acute kidney injury (5.6%), and DIC (5.6%). There were 3 maternal deaths (1.5%). Perinatal mortality was 21.6%, with 7.3% stillbirths and 6.3% intrauterine deaths. Neonatal intensive care admissions occurred in 54.2% of live births, primarily due to prematurity and meconium aspiration.

Conclusion: Abruptio placentae complicating preeclampsia substantially increases maternal and perinatal morbidity and mortality. Early identification of high-risk women, timely referral and multidisciplinary management can reduce adverse outcomes. Routine antenatal screening and optimal control of hypertension remain essential preventive strategies.