Abruptio placentae. An assessment of the time and method of delivery.
Abruptio placentae occurs once per 120 deliveries, but accounts for 15--25% of all perinatal mortality. Several series in the literature suggest that an abnormal fetal-maternal relationship exists in patients with abruptio placentae weeks prior to the actual placental separation and that the separation is only the terminal event. A review of the literature and an analysis of 388 cases of abruptio placentae from the US Navy Coding System were undertaken. It was found that approximately 75% of fetal deaths occurred more than 90 minutes after admission to the hospital and almost 70% of all perinatal mortality occurred in infants who were delivered more than 2 hours from the time of diagnosis. Delivery by cesarean section improved survival in those infants weighing 1500 g or greater and reduced perinatal mortality as much as fourfold in some reports. A prospective study is proposed which would compare two methods of management of this condition.
D000037:Abruptio Placentae / Q000150:complications / Q000453:epidemiology; D001724:Birth Weight; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors