Prognosis of the Babies Born from Placental Abruption - Difference between Intrauterine Fetal Death and Live-Born Infants

Abstract

Objective: To investigate the fetal/neonatal prognosis and to compare Intrauterine Fetal Death (IUFD) with liveborn infants in placental abruption. Methods: A retrospective review of 355 pregnancies was performed. An adverse fetal/neonatal outcome was defined as IUFD on admission, neonatal/ infantile death at discharge and cerebral palsy. Results: Eighty-nine fetuses were cases of IUFD, while the remaining 266 fetuses were alive on admission. The significant factor for IUFD was blood transfusion (OR (odds ratio) 2.21, 95% CI 1.02 - 4.76). The interval from the onset of symptoms to the diagnosis was significantly longer for IUFD than for the live-born infants (median, 213 vs. 130 min, p<0.0001) A logistic regression model showed bradycardia (28.25, 6.10 - 130.84), late decelerations (5.94, 1.02 - 34.61) and gestational age at less than 35 weeks of gestation (5.37, 1.94 - 14.85) were associated with adverse outcomes other than IUFD. The abruption prognosis score was calculated for the occurrence of an adverse neonatal outcome, using four items including gestational age, abdominal pain, bradycardia, and late decelerations. Conclusions: The significant factor associated with IUFD was the interval to the diagnosis and the need for blood transfusion. Adverse outcomes other than IUFD were linked to the gestational age, bradycardia, or late decelerations.