Clinical Profile and Fetomaternal Outcomes of Antepartum Haemorrhage at a Tertiary Care Center in Nepal: A Retrospective Study

Abstract

Introduction: Antepartum haemorrhage is a major obstetric emergency and an important contributor to maternal and perinatal morbidity, particularly in low- and middle-income countries. Delayed presentation, limited accessibility, availability to emergency obstetric care worsens outcomes. This study described the clinical profile and fetomaternal outcomes of Antepartum haemorrhage at a tertiary care center in Nepal.

Methods: A retrospective descriptive study was conducted at a tertiary care center in Nepal. Medical records of all eligible women admitted with Antepartum haemorrhage at ≥28 weeks of gestation and delivered from 1 January 2021 to 31 January 2024 were reviewed. Data were extracted using a structured proforma and summarized using frequencies and percentages or mean ± standard deviation/median (range), as appropriate. Ethical approval was obtained from the Institutional Review Board (Reference: drs2510282140).

Results: Antepartum haemorrhage occurred in 185 of 10,111 (1.83%) deliveries. The mean maternal age was 30.88 ± 4.64 years, and 77 (41.62%) women were primigravida. Placenta previa 78 (42.16%) and abruptio placentae 67 (36.22%) were the leading diagnoses. Postpartum haemorrhage occurred in 64 (34.59%) women, 34 (18.38%) required blood transfusion, and 16 (8.65%) required ICU admission; no maternal deaths were recorded. Preterm delivery occurred in 75 (40.54%) pregnancies, 74 (40.00%) neonates required NICU admission, intrauterine fetal death occurred in 6 (3.24%), stillbirth in 4 (2.16%), and early neonatal death in 19 (10.27%) cases.

Conclusions: Antepartum haemorrhage was accompanied by higher maternal and perinatal morbidity in this tertiary-care cohort, particularly Postpartum haemorrhage, preterm delivery, and Neonatal ICU admission.