Frequency and Clinical Patterns of Placental Abruption and Placenta Previa in Pregnant Women at Tertiary Care Hospital Quetta

Background: Antepartum hemorrhage remains a major cause of maternal and perinatal morbidity in low-resource obstetric settings, particularly where hypertensive disorders, grand multiparity, delayed referral, and inadequate antenatal screening coexist. Placental abruption and placenta previa are the two principal causes, but their frequency and clinical patterns vary across populations. Objective: To determine the frequency and clinical patterns of placental abruption and placenta previa and to compare their maternal and fetal outcomes among pregnant women presenting to a tertiary care hospital in Quetta. Methods: This cross-sectional study was conducted in the Department of Gynecology and Obstetrics, Bolan Medical College/Hospital, Quetta, from May to August 2025. A total of 154 pregnant women beyond 28 weeks of gestation with antepartum hemorrhage due to placental abruption or placenta previa were enrolled consecutively. Diagnosis was based on clinical assessment supported by ultrasonography. Data were analyzed using SPSS version 26.0 with descriptive statistics and chi-square-based comparisons. Results: Placental abruption accounted for 95 cases (61.7%) and placenta previa for 59 cases (38.3%). Hypertension was significantly more common in placental abruption (61.1% vs 15.3%; OR 8.71, 95% CI 3.83–19.79). Blood transfusion requirement (86.3% vs 67.8%), fetal distress or bradycardia (65.3% vs 20.3%), and intrauterine death (18.9% vs 3.4%) were substantially higher in abruption. All previa cases required cesarean delivery, whereas 74.7% of abruption cases underwent cesarean section. Overall maternal mortality was 1.3%. Conclusion: Placental abruption was more frequent than placenta previa in this tertiary care cohort and was associated with markedly greater maternal and fetal compromise. Strengthening antenatal hypertension surveillance, early placental localization, and timely referral may reduce preventable adverse outcomes.