Annual data review on risk factors and immediate maternal and perinatal outcomes in a tertiary hospital in Tanzania

Background: Placenta abruption is an obstetric emergency that rise to major maternal and perinatal morbidity and mortality in low resource countries. It is usually unpredictable, but the risk factors identification is important. These include premature rupture of membranes, oligohydramnios, antepartum hemorrhage, advanced maternal age, multifetal gestation and abdominal trauma. This study aims to review annual data in women with placenta abruption so as to identify the risk factors, presentation mode, management and immediate maternal and perinatal outcomes at Amana Regional Referral Hospital, Dar es Salaam, Tanzania. Methods : Retrospective observational study using medical records of all women who delivered from 28 weeks of gestation at Amana Regional Referral Hospital from January 2023 to December 2023 (n = 159) were analyzed. The results were presented in percentage and frequencies. Data were analyzed in SPSS version 23 software. Results: The incidence of placental abruption was 2.1%Risk factors for placenta abruption were hypertensive disoders of pregnancy, Premature rupture of membranes, previous Caesarean delivery, anaemia during antenatal period and multifetal gestation. Placenta abruption occurred more commmonly in the age group between 20 - 29 years (40%), in their second pregnancy (49.2%) and at a gestation age of 28 - 33+6 weeks. Maternal complications associated with placenta abruption were postpartum hemorrhage , Caesarean delivery, and need for blood transfusion. Coagulopathy, admission to intensive care unit and renal failure were also observed. There was no case of maternal death. Immediate neonatal outcomes were fetal death (83.1%), prematurity (11.9%), early neonatal death (13.6%) and low APGAR score at 5th minute of life. Conclusions: A higher frequency of placenta abruption was observed. Hypertensive disorders in pregnancy was the main risk factor for placenta abruption. Many women with placenta abruption were left to deliver vaginally. Nearly 90% of placenta abruption cases had perinatal death .More efforts should be put in antenatal management of hypertensive disorders in pregnancy to prevent placenta abruption and its complications.