title: Prediction of perinatal outcomes based on primary symptoms in women with placental abruption.
abstract: OBJECTIVE
  Placental abruption is an important cause of perinatal mortality and morbidity. Although there are many reports on the risk factors for placental abruption, there are few on its classification. Our aim is to evaluate the associations between primary symptoms and the outcomes of placental abruption.
  
  
  METHODS
  We carried out a retrospective cohort study of 12,474 births at the Perinatal Center for Maternity and Neonates of the Yokohama City University Medical Center between January 2000 and December 2012. There were 151 women with placental abruption, 136 of whom were included in this study. The subjects were classified into two groups according to their primary symptoms: those with bleeding (external bleeding group) and those with abdominal pain (abdominal pain group). Maternal and neonatal outcomes were compared between the two groups.
  
  
  RESULTS
  Both fetal and maternal outcomes were significantly poorer in the abdominal pain group than in the external bleeding group in terms of intrauterine fetal death (6.5% vs 33.3%, P < 0.001), perinatal mortality (8.1% vs 33.3%, P = 0.001), umbilical arterial pH < 7.1 (15.7% vs 57.1%, P < 0.001), bleeding volume, rate of blood transfusion, and disseminated intravascular coagulation incidence.
  
  
  CONCLUSIONS
  This classification based on primary symptoms was found to be useful for predicting both maternal and neonatal outcomes of placental abruption.
authors.affiliation: Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Michi
authors.initials: M
authors.lastname: Kasai
authors.affiliation: Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Aoki
authors.affiliation: Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Ogawa
authors.affiliation: Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kurasawa
authors.affiliation: Perinatal Center for Maternity and Neonates, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Obstetrics and Gynecology, Yokohama City University Hospital, Yokohama, Japan.
authors.forename: Fumiki
authors.initials: F
authors.lastname: Hirahara
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D000037:Abruptio Placentae / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D000046:Academic Medical Centers; D058070:Asymptomatic Diseases / Q000401:mortality / Q000628:therapy; D001803:Blood Transfusion; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004211:Disseminated Intravascular Coagulation / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005313:Fetal Death / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014592:Uterine Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control
keywords: abdominal pain; concealed abruption; external bleeding; placental abruption; revealed abruption