title: [Fetal death in placental abruption: comparison of two different time periods].
abstract: OBJECTIVE
  To compare the incidence of placental abruption (PA), fetal death and the profile of maternal factors associated with fetal death in pregnancies affected by placental abruption during two different time periods in the same hospital.
  
  
  METHODS
  retrospective study between January 1, 1994 and December 31, 1997 and April 1, 2001 and March 31, 2005, including singleton pregnancies with a birth weight higher than 500 g and gestational age of more than 20 weeks. Factors analyzed were maternal age, race, obstetric history, presence of arterial hypertension or premature rupture of membranes, presence of genital bleeding, presence of amniotic fluid contaminated with blood, characteristics of uterine tonus, occurrence of renal insufficiency, postpartum coagulopathy, puerperal anemia, gestational age and weight at birth.
  
  
  RESULTS
  there were 7692 births in the 1994-1997 period, placental abruption incidence of 0.78% (60 cases); 8644 births occurred in the 2001-2005 period, placental abruption incidence of 0.59% (51 cases), with no statistical difference. During the 1994-1997 period, proportion of cases without genital bleeding was significantly higher in the group whose fetuses died compared to cases of live born fetuses (57.9% vs 22.0%; p=0.01). During the 2001-2005 period, proportion of cases with uterine hypertonia was significantly higher in the group whose fetuses died compared to cases of live born fetuses (66.7% vs 29.3%; p=0.04). Postpartum maternal complications were more frequent in cases of fetal death during both periods (31.6% vs 4.9%; p=0.009; and 50% vs 5.1%; p=0.001, respectively).
  
  
  CONCLUSIONS
  Placental abruption continues to be a serious obstetric problem, with fatal consequences, especially when the placental abruption area is large. Maternal clinical symptoms are more severe in cases of fetal death.
authors.affiliation: Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo- USP, São Paulo, SP. fabiocabar@uol.com.br
authors.forename: Fábio Roberto
authors.initials: FR
authors.lastname: Cabar
authors.forename: Roseli Mieko Yamamoto
authors.initials: RM
authors.lastname: Nomura
authors.forename: Tânia Regina Schupp
authors.initials: TR
authors.lastname: Machado
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000037:Abruptio Placentae / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005313:Fetal Death / Q000453:epidemiology* / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D008423:Maternal Age; D008428:Maternal Mortality; D010298:Parity; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors