Eclampsia and placental abruption: basic patterns, management and morbidity

Abstract

The clinical analysis of 46 cases of abruptio placentae complicating eclampsia showed that, (1) the severity of the eclamptic symptoms influenced the extension of the placental separation, (2) older and multiparous women had more complications, larger placental separations and higher mortality, (3) there were ten maternal deaths due to the additive effects of various complications, (4) total perinatal mortality was 44.7% and it was 40.5% for fetuses above 1000 g, (5) optimum timing of delivery by cesarean operation offered slightly better prognosis, even in cases with antepartum fetal death, (6) the dominant factor for morbidity was the stage reached by the combined pathology before receiving qualified medical care, and (7) the wide variability of these cases suggested that the basis for the complete management should be a series of sound and individually tailored decisions to be carried out in a reasonably short time.

A case of very early onset eclampsia, placental abruption and intrauterine fetal death

“…1,3,5,6) Previous reports suggest that the severity of the eclamptic symptoms influenced the degree of placental separation; in the present case, this was 50%.…”

Pregnancy outcome in severe placental abruption

“…Clinicians confronted with severe abruption and a live fetus have the dilemma of balancing risks for the mother of possible abdominal surgery in a haemodynamically unstable individual with a possible coagulopathy versus possible risks of increased mortality and serious morbidity to the fetus of delay. There is evidence that if the fetal heart rate pattern is normal, then delay such that the maternal status is stabilised, is appropriate 1,2,9–13 . However, the effects of actions of staff are less clear when the fetal heart rate pattern is already severely abnormal.…”