[Placental abruption: Background and revisited pronostic factors about a series of 171 cases].
OBJECTIVE
To describe the epidemiological, clinical and prognostic factors of placental abruption and fetal death in utero and to investigate possible risk factors for their occurrence.


METHODS
Observational retrospective study including the women having presented a placental abruption between January 2001 and January 2012, in a IIB maternity. Women's sociodemographic characteristics, clinical symptoms and the method used to detect placental abruption were collected. Patient data of those whose pregnancy resulted in fetal death were compared to those with more favorable outcomes.


RESULTS
There were 171 cases of placental abruption among 21,913 patients having delivered, which represents a 0.78% incidence. Diagnosis was rarely based on clinical data (30%). The rate of fetal death in utero represented 25% of the pregnancy's outcomes. A history of fetal death in utero increased the risk of placental abruption (P<0.001). This complication was more frequent for patients who did not have pregnancy monitoring (P=0.054) and before 37 weeks of amenorrhoea (P=0.005).


CONCLUSIONS
Placental abruption is an important cause of perinatal mortality and maternal morbidity. Among the observed risk factors, only regular pregnancy monitoring can be an easy way to prevent these complications.
Service de gynécologie obstétrique et médecine de la reproduction, FEH, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France. Electronic address: alexguene@hotmail.fr.
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Gueneuc
Service de gynécologie obstétrique, centre hospitalier de l'Ouest Guyanais, 16, boulevard du Général-Leclerc, BP 245, 97393 Saint-Laurent du Maroni, Guyane française.
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Carles
Service de gynécologie obstétrique et médecine de la reproduction, FEH, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France; Université de médecine de Caen Basse-Normandie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France.
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Lemonnier
Service de gynécologie obstétrique, centre hospitalier de l'Ouest Guyanais, 16, boulevard du Général-Leclerc, BP 245, 97393 Saint-Laurent du Maroni, Guyane française.
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Dallah
Service de santé publique, centre hospitalier de l'Ouest Guyanais, 16, boulevard du Général-Leclerc, BP 245, 97393 Saint-Laurent du Maroni, Guyane française.
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Jolivet
Service de gynécologie obstétrique et médecine de la reproduction, FEH, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France; Université de médecine de Caen Basse-Normandie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France.
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Dreyfus
D000037:Abruptio Placentae / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005616:French Guiana / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
Emergency obstetric bleeding; Fetal death in utero; French Guyana; Guyane française; Hématome rétroplacentaire; Mort fœtale in utero; Mortalité périnatale; Perinatal mortality; Placental abruption; Urgences hémorragie obstétricale