Clinical Analysis of Placental Abruption / 대한주산의학회잡지

ABSTRACT

OBJECTIVE: Placental abruption is one of the obstetric hemorrhage diseases that needs emergent treatment. But there is no predictable tool for placental abruption at present, we clinically analyzed its incidence, etiological factors, signs and symptom and neonatal outcome for reducing complications of this disease. METHODS: The data presented here were based on 80 cases of placental abruption among 20,483 deliveries during 13 years of period from January, 1991 to December, 2003. RESULTS: The incidence of placental abruption was 0.4%. Most of cases (97.5%) occurred over 28 weeks of gestational age. The incidence of unknown etiological factor was 67.5% and pregnancy-induced hypertension was related in 22.5% of cases. The most common signs and symptom was vaginal bleeding (46.3%). Lower abdominal pain (33.8%), fetal distress (10%), premature labor (5%) were also noted. The half of the patients was diagnosed before delivery and the mode of delivery was cesarean section in 93.8%. The survival rate of newborns in severe degree group (14.3%) of placental abruption was lower than that of mild degree group (94.1%) or moderate degree group (84.6%). Additionally, Apgar scores at 1min and 5min of newborns in severe degree group (1.3+/-2.4/1.3+/-3.0) were significantly lower than that of mild degree group (5.9+/-2.5/7.5+/-2.2) or moderate degree group (5.5+/-2.7/7+/-2.8) (p<0.01). There was no maternal death in our study. CONCLUSION: Because the etiological factor of this disease was uncertain in two thirds of cases, comprehension of etiological factor such as pregnancy-induced hypertension and signs and symptom is emphasized. Bleeding and uteroplacental insufficiency caused by placental abruption affect fetal jeopardy in severe cases. Accurate diagnosis and adequate treatment including management of premature baby should be conducted in suspicious case of placental abruption for prevention of progression of this disease.