title: Decision-to-delivery interval in suspected placental abruption - association with pregnancy outcome.
abstract: OBJECTIVE
  To determine the association between decision to delivery interval (DDI) and short-term perinatal outcome in cases of suspected placental abruption delivered by cesarean section (CS).
  
  
  METHODS
  A retrospective cohort study of all cases of placental abruption delivered by CS (2010-2012) in a single university affiliated tertiary center. Composite adverse neonatal and maternal outcome were assessed.
  
  
  RESULTS
  The rate of placental abruption was 0.5% (140/27 677 deliveries) and 65/140 (46%) were delivered by CS. Indications for CS were non-reassuring fetal heart rate (NRFHR) in 32/65 (49.3%), maternal bleeding 20/65 (30.7%) and other indications in 13/65 (20%). Obstetrical and labor characteristics were similar unrelated to the indication for CS. Gestational age at delivery was higher in the group operated due to NRFHR (36 ± 4.3, 34 ± 3.7 and 32 ± 4.1 weeks, respectively, p = 0.03). DDI was shortest when CS was due to NRFHR followed by CS due to maternal bleeding or other indications (23 ± 19, 30 ± 16, 50 ± 40 min, respectively, p = 0.001). The umbilical artery PH was lower in those who operated due to NRFHR (7.17 ± 0.17, 7.23 ± 0.06 and 7.30 ± 0.09, respectively, p = 0.002). The overall rate of neonatal and maternal composite outcome was 66% and 40%, respectively with no significant difference in relation to indication for CS.
  
  
  CONCLUSIONS
  In cases of suspected placental abruption, fetal short-term morbidity is probably related to the indication for CS and not only to DDI.
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center , Petah Tikva , Israel and.
authors.forename: Rinat
authors.initials: R
authors.lastname: Gabbay-Benziv
authors.forename: Eran
authors.initials: E
authors.lastname: Ashwal
authors.forename: Hila
authors.initials: H
authors.lastname: Lahav-Ezra
authors.forename: David
authors.initials: D
authors.lastname: Rabinerson
authors.forename: Arnon
authors.initials: A
authors.lastname: Wiznitzer
authors.forename: Avi
authors.initials: A
authors.lastname: Ben-Haroush
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
mesh_terms: D000037:Abruptio Placentae / Q000453:epidemiology / Q000601:surgery*; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013997:Time Factors
keywords: Cesarean section; neonatal outcome; placental abruption