Epidemiology, Risk Factors, and Perinatal Outcomes of Placental Abruption—Detailed Annual Data and Clinical Perspectives from Polish Tertiary Center

Abstract

Placental abruption (PA) is a separation of the placenta from the uterine wall occurring with the fetus still present in the uterine cavity. It contributes to numerous neonatal and maternal complications, increasing morbidity and mortality. We conducted a retrospective study at a tertiary perinatal care center, which included 2210 cases of labor that took place in 2015 with a PA occurrence of 0.7%. No maternal or fetal death during delivery was reported in this period. The identified PA risk factors were uterine malformations, pPROM, placenta previa spectrum, and oligohydramnios. The significant maternal PA complications identified were maternal anemia, uterine rupture, and HELLP syndrome. Preterm delivery occurred significantly more often in the PA group, and the number of weeks of pregnancy and the birth weight at delivery were both significantly lower in the PA group. PA is a relatively rare perinatal complication with very serious consequences, and it still lacks effective prophylaxis and treatment. Despite its rare occurrence, each center should develop a certain strategy for dealing with this pathology or predicting which patients are at risk. Much work is still needed to ensure the proper care of the mother and the baby in this life-threatening condition.

A clinical study of perinatal and maternal morbidity and mortality in gestational hypertension, preeclampsia and eclampsia

“…Cases with hypertensive pts are 18 (56.3 %), normotensive are 14 (43.7 %), mild PIH 45 (60 %), and severe PIH 30 (40 %) by Bączkowska M et al [13] 2014 which is similar to the present study. The incidence of abruption, PPH, and PPE are due to severe hypertension.…”

The main features of placental abruption: Clinical presentation and treatment

“…Učestalost abrupcije placente kod prevremenih porođaja značajno varira u različitim delovima sveta. U razvijenim zemljama, oko 10% svih prevremenih porođaja izazvano je abrupcijom placente [3,4].…”

“…Kod trudnice, abrupcija placente je skopčana sa rizicima kao što su: akušersko krvarenje, potreba za transfuzijom krvi, hitna histerektomija, diseminirana intravaskularna koagulopatija i bubrežna insuficijencija, a vrlo često je povezana i sa smrću trudnice. Usled prevremenog porođaja, manifestuju se perinatalne komplikacije po plod, kao što su mala porođajna težina novorođenčeta, asfiksija i mrtvorođenost [4,11]. Kompletna abrupcija dovodi do prekida cirkulacije i najvažnije o abrupciji placenteklinička slika i lečenje the main features of placental abruptionclinical presentation and treatment and stillbirth.…”

“…The incidence of placental abruption in preterm births varies significantly in various parts of the world. In developed countries, around 10% of all preterm births are caused by placental abruption [3,4].…”

“…In pregnant women, placental abruption is associated with the following risks: an obstetric hemorrhage, the need of blood transfusion, emergency hysterectomy, disseminated intravascular coagulation and renal failure and very often even maternal death. Due to preterm birth, there may be perinatal complications for the fetus such as low birth weight, asphyxia, and stillbirth [4,11]. Complete abruption leads to the disruption of fetal circulation and oxygenation, asphyxia,…”