Abstract
Objective. The purpose of this study was to elucidate the impact of the clinical presentation on perinatal outcome in placental abruption. Study Design. A retrospective study was performed in 97 placental abruptions. Placental abruptions were classified according to clinical presentation: pregnancy-induced hypertension (HT, n = 22), threatened premature labor and/or premature rupture of membranes (TPL/ROM, n = 35), clinically low risk (LR, n = 27), and others (n = 13). Perinatal outcomes were compared among the HT, TPL/ROM, and LR groups. Results. The HT had significantly higher incidence of IUGR, IFUD, and low fibrinogen. The TPL/ROM had less severe disease. However, the LR had significantly higher incidence of IUFD, low UA pH < 7.1, low Apgar score of <7 at 5 min, and low fibrinogen. Conclusion. Disease severity in placental abruption is likely to depend on the clinical presentation.
Highlights
Placental abruption is a major cause of poor perinatal outcome [1,2,3] and occurs in approximately 1% of all pregnancies [4, 5]
Women presenting with preterm premature rupture of membranes are at increased risk of developing abruption, and histologic chorioamnionitis is associated with placental abruption [7, 8]
According to the histological findings, chorioamnionitis was most marked in the Threatened premature labor (TPL)/rupture of membrane (ROM) group compared to HT and LR (P = .02 and P = .03, Table 4)
Summary
Placental abruption is a major cause of poor perinatal outcome [1,2,3] and occurs in approximately 1% of all pregnancies [4, 5]. Women presenting with preterm premature rupture of membranes (preterm PROM) are at increased risk of developing abruption, and histologic chorioamnionitis is associated with placental abruption [7, 8]. Poor trophoblast invasion to decidua accounts for the etiology of placental abruption [9, 10], and it is agreed that placental abruption occurs with increasing frequency in patients with chronic hypertension [11]. Preterm PROM, threatened premature labor, and hypertension are major risk factors correlated with placental abruption, placental abruption occurs in women without the known risk factors. The frequency of placental abruption is higher in women with preterm PROM or pregnancy-induced hypertension, it is unknown if the severity of placental abruption increases in such cases
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