Clinical Profile and Fetomaternal Outcomes of AntepartumHaemorrhage at a Tertiary Care Center in Nepal: A RetrospectiveStudy

Abstract

Background : Antepartum haemorrhage (APH) is a major obstetric emergency and an important contributor to maternal and perinatal morbidity, particularly in low- and middle-income countries. Delayed presentation, limited access to emergency obstetric care, and associated comorbidities further worsen outcomes. This study aims to evaluate the clinical profile, risk factors, and fetomaternal outcomes of antepartum haemorrhage at a tertiary care center in Nepal. Methods : A retrospective study was conducted at Patan Academy of Health Sciences, Lalitpur, Nepal. All women admitted with APH at ≥28 weeks of gestation from January 2021 to January 2024 were included (n=185). Data was extracted from medical records using a structured proforma. Descriptive statistics, chi-square test, independent t-test, and logistic regression were used for analysis. A p-value of less than 0.05 was considered statistically significant. Results: The incidence of APH was 1.83%. The mean maternal age was 30.88 ± 4.64 years, and 40.9% were primigravida. Placenta previa (42.2%) and abruptio placentae (36.2%) were the leading causes. Maternal complications included postpartum haemorrhage (34.6%), blood transfusion (18.4%), and ICU admission (8.6%), with no maternal mortality. Preterm delivery occurred in 40.5%, and 40.0% of neonates required NICU admission. Intrauterine fetal death, stillbirth, and early neonatal death were observed in 3.2%, 2.2%, and 10.3%, respectively.  Conclusion: APH remains associated with substantial maternal and perinatal morbidity. Strengthening antenatal surveillance and improving timely referral systems are crucial to improving fetomaternal outcomes.