Role of Ultrasound in Detection of Abruptio Placentae and its Clinical Correlation
Introduction: Abruptio placentae is one of the major complications in second half of pregnancy. It accounts for 0.4-1 % of all deliveries. With the advent of ultrasonography, though abruptio placentae has been diagnosed however the sensitivity is less. Those patients clinically suspicious of abruption placenta with negative ultrasound findings can have positive intrapartum findings suggestive of abruptio. Fetal outcome is associated with the gestational age. Preterm deliveries with abruption have higher incidence of perinatal morbidity and mortality as compared to term pregnancies.
Methods: It is a prospective study conducted in Manipal Teaching Hospital, Pokhara from July 2017 to July 2018. All the cases of more than twenty eight weeks gestation, singleton pregnancies without preexisting maternal medical diseases suspicious of abruption placentae were included in the study. Ultrasonological and intrapartum findings were recorded. Data was analyzed using SPSS (VERSION16).
Results: Out of forty patients presented with per vaginal bleeding, sixteen were diagnosed as placental abruption either clinically or ultrasonographically. Only ten patients had positive ultrasound findings of retroplacental clot or subchorionic hemorrhage. Out of six patients with negative ultrasound findings, only four had positive Intrapartum findings suggestive of abruption placenta. The specificity (100%) of ultrasound in diagnosing abruption was more than the sensitivity (71.43%) and the accuracy was 75%.
Conclusion: Ultrasound is less sensitive in diagnosing abruption placenta and the lesser the gestational age, the more in the increase in perinatal morbidity and mortality.