Clinical study on obstetric variables affecting perinatal mortality in placental abruption.
- Author:
Hee Jung JUNG
1
;
Eun Ha JEONG
;
Kyung LEE
;
Hee Ra JUNG
;
Myoung Hwan KIM
;
Ji Kyung KO
;
Yong Kyoon CHO
;
Hoon CHOI
;
Bok Rin KIM
Author Information
1. Department of Obstetrics and Gynecology, College of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea. kjk@sanggyepaik.ac.kr
- Publication Type:Original Article
- Keywords:
Placental abruption;
Hypertension;
Perinatal mortality
- MeSH:
Abruptio Placentae;
Dacarbazine;
Female;
Fetal Death;
Fetal Distress;
Gestational Age;
Hypertension;
Maternal Death;
Myoma;
Perinatal Mortality;
Pre-Eclampsia;
Pregnancy;
Smoke;
Smoking;
Uterine Hemorrhage;
Uterine Rupture;
Uterus
- From:Korean Journal of Obstetrics and Gynecology
2008;51(10):1085-1093
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To evaluate obstetric variables in the placental abruption that affect on perinatal mortality. METHODS: We reviewed clinical data of all singleton deliveries complicated with placental abruption between January 2000 and December 2007, in Department of Ob. & Gyn., Sanggye Paik Hospital. RESULTS: Placental abruption complicated 54 cases (0.55%) of all deliveries (n=9,903) from January 2000 to December 2007. The peak age was 26-30 years (42.1%). The most common symptom was vaginal bleeding (57.4%) and intrauterine fetal death had already occurred in 9.3%. Perinatal mortality rate was 13.0% and there was no maternal death. 38.9% of placental abruption occurred between 33 to 36weeks of gestational age. 38.9% of placental abruption was diagnosed before delivery with ultrasonography and 9.3% was chronic placental abruption. 33.3% of placental abruption was associated with preeclampsia, and then associated with PPROM (24.1%), uterine myoma (3.7%), chronic hypertension (1.9%) and smoking (1.9%). When the hypertensive disorders were associated, fetal distress rate was higher than normotensive pregnancy (63.2% vs 20.0%, P-value: 0.005). Mean gestational age (days) (194+/-32.8 vs 248.12+/-28.0, P-value<0.001) and the severity of placental abruption (P-value: 0.005) affect perinatal mortality in placental abruption. The most common complication of placental abruption was DIC (16 cases, 29.6%), followed by Couvelaire uterus (4 cases, 7.4%) and uterine rupture (1 case, 1.9%). CONCLUSION: Obstetric variables that affect perinatal mortality were gestational age at the diagnosis and the severity of placental abruption.
