The Impact of Diagnosis-to-Delivery Time on Neonatal Outcome as Well as Maternal Morbidity and Mortality in Patients with Abruptio Placenta

Abstract

Aim: The impact of diagnosis-to-delivery time on Neonatal outcome as well as maternal morbidity and mortality in patients with Abruptio placenta Methods: This is a cross-sectional study based on review of clinical records of women diagnosed with abruptio placenta from 1st January 2017 to 31st December 2020. Relevant data was extracted from documentations from the clinical records using a specially designed study form. The data obtained were analysed using Stata 15.0® Statistics. Ethics clearance was obtained from the relevant authorities. Results: The median (IQR) diagnosis to delivery time was 1.2 hrs (72 minutes). The most common cause of prolonged diagnosis to delivery time was that the longest management related time interval was between the diagnosis of abruptio to initiation of anaesthesia of 1.5 hrs and 56 (56.6%) patients were classified as overweight. There were 40 stillbirths and six early neonatal deaths, giving a perinatal mortality rate of 256.6 per 1000 births. There were two maternal deaths. A diagnosis to delivery time of more than 32 minutes was associated with 2.5 likelihood of maternal admission to the obstetric high care or intensive care units and 2.6 likelihood of stillbirth or early neonatal death (p=0.008, 95% CI). Conclusion: Although the optimal decision to delivery time was not achieved in the current study, corrective strategies to reduce decision to delivery time delays should be undertaken which will result in a significant improvement in optimal DDI rate at CMJAH Hospital.