Abruption is a serious complication of pregnancy and a leading cause of maternal and perinatal mortality & morbidity. The objective of the study was to identify risk factors for placental abruption that may be amenable to interventions which can results in impaired feto maternal outcome.

Materials and Methods: This was a case control study conducted in SAT Hospital, Thiruvananthapuram. A total of 77 cases of abruption and controls were investigated. Statistical analysis for comparing low risk factors were done using Chi square test, Student's test and 'p' value, Odd's Ratio (OR) and confidence intervals were also calculated.

Results: There were 77 cases of abruption during the study period. Advanced maternal age (OR - 5.87, CI - 0.135-0.618), multiparty (OR - 4.6 CI - 1.2-18.1) were significantly associated with abruption. Increased incidence of abruption was found among low socioeconomic status and referred cases. PIH was a major risk factor associated with abruption (27.3% vs 9% in controls). P < 0.01

Conclusions: The results indicate that placental abruption is an obstetric emergency with maternal and perinatal mortality. Advanced maternal age, multiparity, low socioeconomic status were the major sociodemographic factors associated with abruption. Previous caesarian delivery and PIH were the obstetric risk factors for abruption.

Keywords: Risk factors, abruptio placentae, feto maternal outcome.

1. Kramer MS, Usher RH, Pollack R, Boyd M, Usher S (1997) : Etiologic determinants of abruptio placentae. Obstet Gynecol, 89:221-226
2. Sheiner E, Shoham-Vardi I, Hallak M, Hadar A, Gortzak- Uzan L, Katz M, Mazor M (2003) : Placental abruption in term pregnancies: clinical significance and obstetric risk factors. J Matern Fetal Neonatal Med., 13(l):45-9
3. Toivonen S, Heinonen S, Anttila M, Kosma VM, Saarikoski S (2002) : Reproductive risk factors, Doppler findings, and outcome of affected births in placental abruption: a population-based analysis. Am J Perinatol, 19(8):451-60.
4. Rasmussens, Irgens LM, Bergsjo P, Dalaker K (1996a) : The occurrence of placental abruption in Norway 1967-91. Acta Obstet Gynecol Scand 75:222-228.
5. Pritchard JA, Cunningham FG, Pritchard SA, Mason RA (1991): On reducing the frequency of severe abruptio placentae. Am J Obstet Gynecol 165:1345
6. Ananth CV, Savitz DA, Luther ER (1996) : Maternal cigarette smoking as risk factor for placental abruption, placenta previa, and uterine bleeding in pregnancy. Am J Epidemiol, 144(9): 881-9.
7. Prochazka M, Kudela M, Lubusky M, Vetr M, Hrachovec P, Zielina P (2005) : Premature separation of the placentae - etiology and risk factors. CeskaGynecol, 70(3): 175-9.
8. Ananth CV, Savitz DA, Luther ER (1996) : Maternal cigarette smoking as risk factor for placental abruption, placenta previa, and uterine bleeding in pregnancy. Am J Epidemiol, 144(9): 881-9.
9. Naeye RL, Tafari N, Marbac CC (1979) : Perinatal death due to abruptio placentae in an African city. Acta Obstet Gynecol Scand 58:37-40.
10. Lydon-Rochelle M, Holt VL, Easterling TR, Martin DP (2001)First-birth cesarean and placental abruption or previa at second birth. Obstet Gynecol, p. 765-9.
11. Rasmussen S, Irgens LM, Dalaker K. A history of placental dysfunction and risk of placental abruption. Paediatr Perinat Epidemiol. 1999 Jan; 13(1):9-21.
12. Morgan MA, Berkowitz KM, Thomas SJ, Reimbold P, Quilligan EJ (1994) : Abruptio placentae: Perinatal outcome in normotensive and hypertensive patients, 170:1595-1599.
13. Ananth CV, Savitz DA, Bowes WA Jr., Luther ER (1997) : Influence of hypertensive disorders and cigarette smoking on placental abruption and uterine bleeding during pregnancy. BJOG (1997) 104:572-578.
14. Ananth CV, Smulian JC, Vintzileos AM (1999) : Incidence of placental abruption in relation to cigarette smoking and hypertensive disorders during pregnancy: a meta-analysis of observational studies. Obstet Gynecol, 93(4):622-8.
15. Dafallah SE, Babikir HE (2004) : Risk factors predisposing to abruptio placentae. Maternal and fetal outcome. Saudi MedJ., 25(9): 1237-40.

Dr Shyja JS

Post graduate student, Dept of Obstetrics and Gynaecology, SATH, Govt. Medical College, Thiruvananthapuram