Pregnancy outcomes in placental abruption.
OBJECTIVE
To determine the outcomes of pregnancies with placental abruption and to investigate the relationship between clinical maternal characteristics and poor perinatal outcomes.


METHODS
A retrospective descriptive study was conducted to evaluate 103 cases of placental abruption delivered at King Chulalongkorn Memorial Hospital from 1995 to 2004.


RESULTS
There were 111,375 singleton deliveries with 103 cases (0.92 in 1,000) complicated by placental abruption during the study period. Placental abruption attributed to maternal complications including hemorrhagic shock (19.4%), Couvelaire uterus (16.5%) and DIC (5.8%). The perinatal outcomes included low birth weight (65.0%), preterm (56.3%), severe birth asphyxia (16.5%) and perinatal death (16.5%). Placental abruption with pregnancy induced hypertension (PIH), DIC and blood transfusion had a significantly higher incidence of perinatal mortality than the remainder (odds ratio [OR] 4.16, 95% confidence interval [CI] 1.41-12.24; OR 12.92, 95%CI 2.15-77.80 and OR 3.93, 95%CI 1.27-12.19, respectively). Placental abruption with Couvelaire uterus had a significantly higher incidence of severe birth asphyxia than the remainder (OR 3.72, 95%CI 1.14-2.09).


CONCLUSIONS
Placental abruption had a profound impact on both maternal and perinatal complications including DIC, Couvelaire uterus, severe birth asphyxia and perinatal death. The relationship between PIH, DIC, blood transfusion and Couvelaire uterus with poor perinatal outcomes were found Therefore, placental abruption with these clinical characteristics should be closely monitored and prompt delivery should be carried out at tertiary care centers with adequate maternal-neonatal intensive care facilities.
Pitaphrom
Amornrath
A
Department of Obstetrics & Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
Sukcharoen
Nares
N
D000037:Abruptio Placentae / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D001238:Asphyxia Neonatorum / Q000453:epidemiology / Q000209:etiology; D004211:Disseminated Intravascular Coagulation / Q000150:complications; D005260:Female; D005313:Fetal Death; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D012771:Shock, Hemorrhagic / Q000150:complications; D013785:Thailand