title: Prediction of fetal acidemia in placental abruption.
abstract: BACKGROUND
  To determine the major predictive factors for fetal acidemia in placental abruption.
  
  
  METHODS
  A retrospective review of pregnancies with placental abruption was performed using a logistic regression model. Fetal acidemia was defined as a pH of less than 7.0 in umbilical artery. The severe abruption score, which was derived from a linear discriminant function, was calculated to determine the probability of fetal acidemia.
  
  
  RESULTS
  Fetal acidemia was seen in 43 survivors (43/222, 19%). A logistic regression model showed bradycardia (OR (odds ratio) 50.34, 95% CI 11.07-228.93), and late decelerations (OR 15.13, 3.05-74.97), but not abnormal ultrasonographic findings were to be associated with the occurrence of fetal acidemia. The severe abruption score was calculated for the occurrence of fetal acidemia, using 6 items including vaginal bleeding, gestational age, abdominal pain, abnormal ultrasonographic finding, late decelerations, and bradycardia.
  
  
  CONCLUSIONS
  An abnormal FHR pattern, especially bradycardia is the most significant risk factor in placental abruption predicting fetal acidemia, regardless of the presence of abnormal ultrasonographic findings or gestational age.
authors.affiliation: Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Kawada-cho, 8-1, Shinjuku-ku, Tokyo 162-8666, Japan. yoshiom2979@gmail.com
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Matsuda
authors.forename: Masaki
authors.initials: M
authors.lastname: Ogawa
authors.forename: Jun
authors.initials: J
authors.lastname: Konno
authors.forename: Minoru
authors.initials: M
authors.lastname: Mitani
authors.forename: Hideo
authors.initials: H
authors.lastname: Matsui
mesh_terms: D015746:Abdominal Pain / Q000150:complications; D000037:Abruptio Placentae / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery; D000143:Acids / Q000097:blood*; D019540:Area Under Curve; D001919:Bradycardia / Q000150:complications; D002585:Cesarean Section; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005315:Fetal Diseases / Q000097:blood* / Q000209:etiology; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D006863:Hydrogen-Ion Concentration; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014463:Ultrasonography; D014469:Umbilical Arteries; D014592:Uterine Hemorrhage / Q000150:complications
chemical_list: D000143:Acids
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