Risk and Risk Estimation of Placental Abruption

Abstract

Short title: Risk estimation of placental abruption 2 CONDENSATION Prior second trimester, third trimester, and repeated fetal loss may be used to predict increased risk of placental abruption. Lindqvist PG ABSTRACTObjective: Several variables related to increased risk of placental abruption are also risk factors for venous thromboembolism. Prior second trimester-, third trimester, and repeated fetal loss are reported to be associated to thrombophilias. However, it is yet not known if they are also related to placental abruption. Study design:A retrospective case-control study of 161 women with placental abruption and 2,371 unselected gravidae without placental abruption. The medical files were scrutinized and the selected variables were investigated in relation to the development of placental abruption.Results: As compared to controls, previous second trimester-, third trimester-, repeated fetal loss, and prior placental abruption were related to a 3-fold, 13-fold, 3-fold, and a 25-fold increased risk of placental abruption, respectively. Several other factors were associated with a roughly three-fold increased risk such as: preeclampsia, IUGR, high maternal age (> 35), family history of venous thromboembolism, smoking, and multiple birth. A risk score was created and as compared with those with no risk factors present, the risk of placental abruption was increasing from 2.5-fold for those with risk score = 1, to almost 100-fold for risk score 4 or above. Conclusion:Easily obtainable information might be used to classify the risk of placental abruption.

Etiology, clinical manifestations, and prediction of placental abruption

“…There is some evidence that placental abruption occurs in families (47)(48)(49). According to one study, placental abruption appears to cluster in families of an index patient with recurrent placental abruption (47). According to another study, 5% of women with abruption reported first degree relatives with abruption (48).…”

“…Risk factor analysis. Risk score analyses and mathematical modeling have been developed in order to predict placental abruption (47,78). An analysis of 52 obstetric risk factors related to placental abruption was used to create a mathematical model (78).…”

“…The cumulative risk could be calculated mathematically. In another study, each risk factor was given a score from 1 to 3 depending of the odds ratio and a total score was calculated (47). The investigators concluded that the easily available information on risk factors might be used to derive a risk score for placental abruption.…”

Abruptio Placentae – Risk Factors and Clinical Manifestations

“…[3] . Recently placental abruption has been reported to be more prevalent in patients with thrombophilia and in women with family history of venous thromboembolism [4] .…”

Analysis of Risk Factors for Uteroplacental Apoplexy Complicating Placental Abruption: A Systematic Review

“…Placental abruption refers to the separation of a normally sited placenta from the uterine wall after 20 weeks of gestation and prior to birth [1]. Abruption is the most common cause of late pregnancy bleeding [2], and is associated with significant perinatal mortality and morbidity [3].…”