Abstract
The purpose of this paper was to examine the obstetric and neonatal outcomes of preterm singleton pregnancies complicated by placental abruption following preterm premature rupture of membranes (p-PROM) compared with those without p-PROM. We reviewed the obstetric records of 95 singleton deliveries complicated by placental abruption at 22–36 weeks' gestation. The incidence of placental abruption in singleton pregnancies with p-PROM was 4.7%, and the crude odds ratio of placental abruption for women following p-PROM was 6.50 (P < 0.01). Of the 95 cases of placental abruption in preterm singleton deliveries, 64 cases (67.4%) occurred without p-PROM and 31 cases (32.6%) occurred following p-PROM. The incidence of histological chorioamnionitis stage III in the patients following p-PROM was significantly higher than that in the patients without p-PROM (P = 0.02). The rate of emergency Cesarean deliveries associated with nonreassuring fetal status (NRFS) in the patients following p-PROM was significantly lower than that in the patients without p-PROM. However, there were no significant differences in the maternal and neonatal outcomes between the patients with and without p-PROM. Although p-PROM may be one of important risk factors for placental abruption associated with chorioamnionitis, it may not influence the perinatal outcomes in preterm placental abruption.
Highlights
Placental abruption or premature separation of the normally implanted placenta is a serious and life-threatening obstetric complication for both mother and fetus [1,2,3]
Evidence from prior studies suggests that women exposed to prolonged preterm premature rupture of membranes (p-PROM) are at increased risk of placental abruption [9,10,11], because recent evidence has linked neutrophil infiltration into the deciduas with preterm placental abruption [2, 7]
The major findings of the current study are: (1) the preterm singleton pregnancies complicated by placental abruption following p-PROM was strongly associated with the presence of histological CAM more than those without p-PROM, and (2) the perinatal outcomes of preterm placental abruption following p-PROM were not different from those without pPROM at preterm
Summary
Placental abruption or premature separation of the normally implanted placenta is a serious and life-threatening obstetric complication for both mother and fetus [1,2,3]. The cause of placental abruption remains elusive, the presence of inflammation and infection has been suggested to be the primary cause of placental abruption [2, 4,5,6,7,8]. Evidence from prior studies suggests that women exposed to prolonged preterm premature rupture of membranes (p-PROM) are at increased risk of placental abruption [9,10,11], because recent evidence has linked neutrophil infiltration into the deciduas with preterm placental abruption [2, 7]. In our earlier studies [12, 13], for example, the incidence of preterm delivery, p-PROM, and low birth weight in the cases of placental abruption with chorioamnionitis were higher than in cases without chorioamnionitis: there were no significant differences in the incidence of other outcomes between the cases of placental abruption with and without histological chorioamnionitis. There have been few examinations concerning the influence of precedent p-PROM on the severity of placental abruption at preterm only
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