Prospective evaluation of placental abruption in nulliparous women

Lueth, Amir J.; Blue, Nathan R.; Silver, Robert M.; Allshouse, Amanda A.; Hoffman, Matthew; Grobman, William A.; Simhan, Hyagriv N.; Reddy, Uma M.; Haas, David M.

doi:10.1080/14767058.2021.1989405

Cited by 12 publications

(12 citation statements)

References 24 publications

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“…In the nuMoM2b study, risk factors for placental abruption were studied in 9450 females. 141 For females with abruption, the mean gestational age at delivery was 35.6±4.4; it was 38.8±2.2 weeks for females without abruption. Gravidity was associated with abruption (OR, 3.1 [95% CI, 1.6–6.0]).…”

Section: Adverse Pregnancy Outcomesmentioning

confidence: 97%

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Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2023

Circulation

3,590

702

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BACKGROUND: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS: The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year’s worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year’s edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS: Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS: The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

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Section: Adverse Pregnancy Outcomesmentioning

confidence: 97%

“…140 In the nuMoM2b study, placental abruption was identified in 62 (0.66%) of 9450 nulliparous females: 35 (56%) were antepartum and 27 (44%) were intrapartum. 141…”

Section: Adverse Pregnancy Outcomesmentioning

confidence: 99%

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Tsao¹,

Aday²,

Almarzooq³

et al. 2023

Circulation

3,590

702

View full text Add to dashboard Cite

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“…Various neonatal morbidities caused by placental abruption can be largely associated with neonatal prematurity 14,15 . As shown in Table 2, all cases in the poor group delivered between 28 and 36 weeks of gestation.…”

Section: Discussionmentioning

confidence: 97%

Impact of maternal late hospital arrival on adverse outcome of offspring affected by placental abruption: A regional multicenter nested case–control study in Japan

Kawamura

Takahashi

Miyazaki

et al. 2023

J of Obstet and Gynaecol

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Aims To elucidate the influence of the time‐intervals between the onset and arrival (TIME 1), onset and delivery (TIME 2), and the decision to deliver and delivery (TIME 3) on severe adverse outcomes of offspring born to mothers complicated by placental abruption outside the hospital. Methods This is a multicenter nested case–control study about placental abruption at Fukui Prefecture, a regional area in Japan, through 2013 to 2017. Multiple pregnancy, fetal or neonatal congenital abnormality, and unknown detailed information at onset of placental abruption were excluded. A composite of perinatal death and cerebral palsy or death at 18–36 months of corrected age was defined as the adverse outcome. The relationship between time‐intervals and the adverse outcome was analyzed. Results The 45 subjects for analysis were divided into two groups, including a group with and without adverse outcome (poor, n = 8; and good, n = 37). TIME 1 was longer in the poor group (150 vs. 45 min, p < 0.001). A subgroup analysis targeted to 29 cases with preterm birth at the third trimester indicates that TIME 1 and TIME 2 were longer in the poor group (185 vs. 55 min, p = 0.02; and 211 vs. 125 min, p = 0.03), while TIME 3 was shorter in the poor group (21 vs. 53 min, p = 0.01). Conclusions Long time‐intervals between onset and arrival or onset and delivery may be correlated with perinatal death or cerebral palsy in surviving infants affected by placental abruption.

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“…Adverse perinatal outcomes of pregnancies complicated with placental abruption include low Apgar score, preterm birth, lower birth weight, and perinatal mortality 2,11,[26][27][28][29][30][31][32][33][34] . 64% of our patients with placental abruption were delivered prematurely.…”

Section: Discussionmentioning

confidence: 99%

“…Its incidence is higher in Canada and the United States and lower in Norway, Spain, Finland, Sweden, the Netherlands, and Denmark 1 . The overall incidence is approximately 3 to 10 per 1000 births 1,2 . Clinical presentation of placental abruption includes painful vaginal bleeding with uterine contraction and hypertonicity and a non-reassuring fetal heart rate pattern 3 .…”

Section: Introductionmentioning

confidence: 99%

Incidence, risk factors, and clinical outcomes of placental abruption in a tertiary hospital in Hong Kong: a retrospective case-control study

Shek

Kwong

et al. 2023

Hong Kong Journal of Gynaecology, Obstetrics and Midwifery

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Introduction:This study aims to identify risk factors for placental abruption and evaluate maternal and fetal outcomes of patients with placental abruption in a tertiary hospital in Hong Kong. Methods: Medical records of patients with placental abruption treated at the Tuen Mun Hospital between January 2017 and December 2021 were retrospectively reviewed. Data retrieved included patient demographics, alcohol/ substance abuse and smoking status, obstetric history, antenatal characteristics, body mass index at first antenatal visit, clinical presentation, intrapartum events, complications, and maternal and perinatal outcomes. Each patient was matched with a control who delivered just before the patient. Results: Of 22 990 deliveries and 23 230 live births, there were 86 placental abruption cases; the incidence was 0.37%. After adjusting for confounders, the risk factor for placental abruption was a history of antepartum haemorrhage. Compared with controls, patients with placental abruption had higher rates of caesarean sections (91.9% vs 23.3%, p<0.001), postpartum haemorrhage (62.8% vs 15.1%, p<0.001), uterine atony (31.4% vs 3.5%, p<0.001), blood transfusion (25.6% vs 3.5%, p<0.001), and disseminated intravascular coagulopathy (7.0% vs 0%, p=0.029). Compared with controls, neonates complicated with placental abruption had lower Apgar score at 1 minute (7 vs 8, p<0.001), higher preterm birth rate (64.0% vs 9.3%, p<0.001), lower birth weight (2296.4 g vs 3088.8 g, p<0.001), and more perinatal morbidities. Patients with a Couvelaire uterus had higher rates of uterine atony (56.3% vs 27.0%, p=0.026), postpartum haemorrhage (93.8% vs 61.9%, p=0.014), disseminated intravascular coagulopathy (25.0% vs 3.2%, p=0.014), blood transfusion (68.8% vs 17.5%, p<0.001), and secondary intervention (25.0% vs 1.6%, p=0.005). Neonates born from patients with a Couvelaire uterus had higher rates of acidosis (umbilical cord blood pH <7.1) [53.3% vs 5.8%, p<0.001], lower Apgar score at 1 minute (25.0% vs 4.8%, p=0.028), and hypoxic-ischaemic encephalopathy (12.5% vs 0%, p=0.039). Conclusion:Clinicians should be vigilant for placental abruption in patients with antepartum haemorrhage, especially in high-risk patients with a history of placental abruption, hypertension, or pre-eclampsia. Early and consistent antenatal care is imperative to identify those with risk factors. Proper education and timely preventive management should be provided to improve maternal and fetal outcomes.

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Prospective evaluation of placental abruption in nulliparous women

Cited by 12 publications

References 24 publications

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association

Impact of maternal late hospital arrival on adverse outcome of offspring affected by placental abruption: A regional multicenter nested case–control study in Japan

Incidence, risk factors, and clinical outcomes of placental abruption in a tertiary hospital in Hong Kong: a retrospective case-control study

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