Placental Abruption: A Five-Year Experience at a Tertiary Health Facility in Enugu State University Teaching Hospital, Parklane, South-East Nigeria
Kelvin Emeka Ortuanya
*
Department of Obstetrics and Gynaecology, Enugu State University of Science and Technology, Enugu, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Placental abruption is a serious obstetric complication associated with significant maternal and perinatal morbidity and mortality, particularly in low-resource settings. Despite advances in obstetric care, outcomes remain poor due to late presentation and limited diagnostic and management facilities.
Objective: To review the risk factors, clinical presentation, management, and maternal and perinatal outcomes of placental abruption at Enugu State University Teaching Hospital (ESUTH), Parklane, over a five-year period.
Methods: This was a retrospective descriptive study conducted at ESUTH, Enugu, Nigeria, reviewing cases of placental abruption from January 2021 to December 2025. Data were obtained from labour ward registers, case notes, theatre records, and neonatal records using a structured proforma. Variables analyzed included socio-demographic characteristics, clinical features, obstetric parameters, and maternal and neonatal outcomes. Data were analyzed using SPSS version 25.0, with results presented as frequencies and percentages. Chi-square test was used to assess associations, with significance set at p < 0.05.
Results: A total of 108 cases were analyzed. The majority of patients were aged 30–39 years (50%), married (62%), unemployed (56.5%), and of low socioeconomic status. Most patients (63.9%) were unbooked. The most common clinical features were abdominal pain (99.1%) and uterine hypertonicity (97.2%), while vaginal bleeding occurred in 55.6% of cases. Hypertensive disorders were present in 48.1% of patients. Most women were multiparous (72.2%), and 66.7% of pregnancies were at term. Caesarean section was the predominant mode of delivery (71.3%). Maternal complications included blood transfusion (30.6%), disseminated intravascular coagulation (5.6%), shock (9.3%), and acute kidney injury (1.9%), with a maternal mortality rate of 7.4%. Perinatal outcomes showed a mortality rate of 7.4% and NICU admission rate of 11.1%. Low Apgar scores (<5) were observed in 8.3% of neonates.
Conclusion: Placental abruption remains a major obstetric emergency at ESUTH, associated with significant maternal and perinatal morbidity and mortality. Hypertension and lack of antenatal care were key contributing factors. Improved antenatal surveillance, early diagnosis, and prompt intervention are essential to improving outcomes.
Keywords: Placental abruption, maternal outcomes, perinatal mortality, hypertension