Vol. 60, No. 6, June 2010 443 Original Article Abruptio placenta and adverse pregnancy outcome Nazli Hossain, 1 Nusrat Khan, 2 Syeda Seema Sultana, 3 Nazeer Khan 4 Department of Obstetrics& Gynecology Unit-3, Civil Hospital & Dow University of Health Sciences, 1-3 Dow University of Health Sciences, 4 Karachi, Pakistan. Abstract Objective: To determine the risk factors in pregnancies complicated with abruptio placenta Methods: Case-control study. The study was conducted at department of Obstetrics and Gynecology Unit 3, Civil Hospital, Dow University of Health Sciences Karachi. The study period was from January to December 2008. All pregnant women who were diagnosed with abruptio placenta after 28 weeks of gestation were included in the study. They were compared with women who had live birth during the study period. This group was taken as controls. Both groups were identified from the admission, labour room registers. Results: Total number of deliveries during the study period was 2610. Patients identified with abrupio placenta were 81, giving a frequency of 3.75%. Majority (44%) of women were between 26-30 years of age group. Forty three (54%) of the women were second, third or fourth gravida. The mean gestational age was 34 ± 4.21 weeks. Forty one (51%) delivered preterm before 37 weeks and 40 (49%) delivered at or after 37 completed weeks of gestation. Vaginal delivery was the main mode of delivery, followed by Caesarean section. Vaginal bleeding was the most common clinical finding seen in 80% (68/81) women, followed by blood stained amniotic fluid in 45% (37/81). Foetal heart sounds were absent on admission in 65% (53/81). There were two maternal deaths due to postpartum haemorrhage. The perinatal mortality rate was 66% (54/81). Parity and gestational age were found to be significant risk factors for abruptio placentae (p < 0.031 and p < 0.001 respectively). Conclusion: Abruptio placenta is associated with poor maternal and foetal outcomes (JPMA 60:443; 2010). Introduction Abruptio placenta, is defined as complete or partial separation of placenta before delivery. It occurs in around 1% of all pregnancies. 1 Etiology of abruptio placenta (AP), has not been well defined. Risk factors which have been found associated with AP include maternal age, parity, smoking, hypertension, past history of AP, thrombophilic disorders, abdominal trauma, polyhydramnios. It has been associated with chorioamnionitis, in both term and preterm gestation. 2 Both maternal and paternal smoking have been found to be significantly associated with abruption. 3 Abruptio placenta has been associated with poor maternal and foetal outcomes. Maternal complications of AP include postpartum haemorrhage with its sequelae of acute tubular necrosis, disseminated intravascular coagulation. Abruptio placenta has also been found to be associated with poor perinatal outcome, including low birth weight, increased incidence of Prematurity and still birth. 4,5 The purpose of this study was to determine the clinical characteristics and outcome of pregnancies diagnosed as abruptio placenta. Patients and Methods This study was done at Department of Obstetrics and Gynaecology Unit 3, Civil Hospital Karachi and Dow University of Health Sciences The department mainly receives patients referred from peripheral hospitals of Sindh and Baluchistan provinces of country. Majority of these women