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PubMed1986

Intrauterine aplastic anemia and fetal hydrops: a case report.

Fetal hydrops developed in the 8-day interval between two ultrasonographic examinations of a pregnant woman who had presented with a revealed placental abruption. Chronic ulcerative colitis had been treated with oral prednisone and sulfasalazine until the second month of pregnancy and then with prednisone only. An autolysed hydropic fetus was delivered at 26 weeks gestation. No hematopoietic tissue was identified in the small pale fetal liver, in the bone marrow, or in other organs. No cause for hydrops other than the aplastic anemia was identified.

Abruptio Placentae↗
PubMedDate not supplied

Caesarean section and birth weight at Korle Bu Teaching Hospital--preliminary report.

OBJECTIVE: This preliminary retrospective survey was done to find out whether the indications for Caesarean Section had any bearing on the birth weight. METHOD: The foetal outcome for 673 parturients who delivered at the Korle Bu Teaching Hospital between September 1, 1998 and December 31, 1998 was analysed. RESULT: Caesarean section done for cephalopelvic disproportion and for 2 or more previous sections yielded the highest mean birth weight (3.43 kg +/- 0.02 kg) and the best foetal outcome. Hypertensive disorders yielded the lowest mean birth weight (1.8 kg +/- 0.3 kg) and poorest foetal outcome. The mean parity and age of the parturients were similarly distributed. CONCLUSION: The birth weights appeared to vary with the indications for Caesarean section. Confounding factors such as the gestational age, parity and age of the parturients need to be controlled in a prospective study in future. Good antenatal supervision could improve on the birth weights.

Abruptio Placentae↗
PubMed1975

Birth weight in pregnancies after induction of ovulation with pituitary gonadotrophins.

Birth weights offer a means of determining normality of babies born after induction of ovulation with human pituitary gonadotrophins. A study of 62 patients treated under the auspices of the Australian Human Pituitary Advisory Committee shows that birth weights of the babies were not significantly different from those in two large Australian obstetric populations. Multiple pregnancies are more common after ovulation induction. Birth weights in twins are approximately 85% of those in singleton pregnancies.

Abruptio Placentae↗
PubMed1977

Motor-car accidents during pregnancy.

Motor-car accidents in the State of Victoria in the years 1973 to 1975 inclusive resulted in five maternal and 27 fetal deaths. Severe maternal injury only occurred in women not wearing seat belts; however, fetal death may well have been due to seat belt injury in 14 subjects. The commonest genital tract injury was placental abruption.. However, uterine rupture was observed on three occasions and these cases are described in detail.

Abruptio Placentae↗
PubMed2002

Clinical utility of sonography in the diagnosis and treatment of placental abruption.

OBJECTIVE: To determine the sensitivity and specificity of sonography for detection of placental abruption and whether sonographic results correlate with management or outcome. METHODS: We identified 149 consecutive patients who underwent sonography at 24 weeks' gestational age or later for ruling out abruption or vaginal bleeding. Obstetric and neonatal data were obtained from the hospital perinatal database. Sonographic results, pathologic reports, and hospital charts were reviewed. Sonographic sensitivity, specificity, and positive and negative predictive values were calculated, and regression was used to determine independence of associations. RESULTS: Of the 149 patients, 17 (11%) had sonographic evidence of abruption, and 32 (21%) had evidence of abruption at delivery. As the scan-to-delivery interval decreased, the positive predictive value increased and the negative predictive value decreased. Of 55 patients who gave birth within 14 days of sonography, 8 (15%) had scans consistent with abruption, and 29 (53%) had abruption at delivery; the sensitivity, specificity, and positive and negative predictive values of sonography were 24%, 96%, 88%, and 53%, respectively. Positive sonographic findings were univariately associated with 2- to 3-fold greater subsequent tocolysis, betamethasone use, duration of hospitalization, follow-up sonograms, preterm delivery, low birth weight, and neonatal intensive care unit admission. All but low birth weight and neonatal intensive care unit admission remained independently significant after adjustment for gestational age (P < .05). CONCLUSIONS: Sonography is not sensitive for detection of placental abruption, but a positive finding is associated with more aggressive management and worse neonatal outcome.

Abruptio Placentae↗
PubMed1999

Multiple pregnancies with single intrauterine demise. Description of twenty-eight pregnancies.

METHODS: Retrospective study of multiple pregnancies and deliveries with single intrauterine demise, in a five years' study period. RESULTS: Of a total of 13,840 deliveries in the study period, 355 represented multiple pregnancies with two or more fetuses from conception: 310 twin pregnancies and 45 triplets or higher. Twenty-eight multiple pregnancies were complicated by single intrauterine death: in six cases (group A) as first trimester spontaneous fetal loss, in nine cases (group B) due to selective fetal reduction, and in thirteen pregnancies as spontaneous intrauterine demise occurring in the second or third trimester (group C). In group A, no specific cause of death was proven. In group C, four cases of death were caused by twin transfusion syndrome, three cases by severe intrauterine growth retardation, four cases by placental insufficiency, one case by placental abruption striking one of the twins, whereas the last death was undefined. In group A, mean gestational age at delivery was 33 completed weeks. In group C, five monochorionic pregnancies were delivered at median gestational age 30 weeks and seven dichorionic pregnancies at 34 weeks (the chorionicity was indefinite in one case). The neonatal complications of the forty-two live born babies included prematurity problems only, except for one case of congenital anemia in a transfusion syndrome donor twin. None of the mothers showed signs of intravascular coagulopathy. CONCLUSION: The main problem for the surviving twin was prematurity - not the sibling's death.

Abruptio Placentae↗
PubMed1999

Limb deformations in oligohydramnios sequence: effects of gestational age and duration of oligohydramnios.

In order to study the pathogenesis of prenatal deformities, we reviewed maternal histories, delivery records, pathology reports, radiographs, and photographs of 90 fetuses with prenatally documented oligohydramnios at gestational ages from 14 weeks to term. The causes of oligohydramnios included premature rupture of membranes (44 cases), fetal renal insufficiency (25 cases), idiopathic (15 cases), and twin-twin transfusion (6 cases). The fetuses were grouped according to gestational age at delivery and duration of oligohydramnios. Sixty-three fetuses (70%) had documented contractures. As expected, contractures were more frequent with earlier onset and longer duration of oligohydramnios. During the 2nd trimester, the frequency of contractures in fetuses with oligohydramnios was 77% compared to 52% in the 3rd trimester (chi(2) = 5.33, 1 df, P =.02). Considering all gestational ages together, 57% of fetuses had contractures after less than 2 weeks of oligohydramnios compared to 81% of fetuses with a longer duration of oligohydramnios (chi2 = 6.23, 1 df, P <.02). The type of contracture varied with gestational age. Clubfoot was the most frequent at all ages, but hand contractures such as camptodactyly were common only in the 2nd trimester while the broad flat hand originally described in Potter sequence was found almost exclusively in the fetuses with oligohydramnios in the 3rd trimester. Of the 63 fetuses with oligohydramnios and contractures, 25 (40%) had either additional malformations or family history that could explain contractures independent of oligohydramnios.

Abruptio Placentae↗
PubMed2000

Prediction of maternal and fetal complications in preeclampsia.

INTRODUCTION: Preeclampsia is associated with an increased risk for maternal and fetal morbidity. The aim of this study was to identify factors predicting for maternal or fetal complications. MATERIAL AND METHODS: One hundred and eleven patients with preeclampsia were included. Endpoint variables were maternal and fetal complications. Any of the diagnosis eclampsia, hemolysis elevated liver low platelet (HELLP) syndrome, oliguria or placental abruption was considered a maternal complication. Fetal complications were: small for gestational age (SGA) infant, umbilical artery pH<7.10 and admittance of the infant to a neonatal intensive care unit (NICU). Independent variables were maternal age, parity, gestational age, renal function, platelet count, liver enzymes and blood pressure. Logistic regression analysis was used for statistical evaluation. RESULTS: The following independent significant predictors were identified: Maternal complication (n=10) was predicted only by diastolic blood pressure; odds ratio (OR) 1.13 (95% confidence interval 1.01-1.25). SGA (n=21) was associated with maternal prepregnancy weight, OR 0.94 (0.89-0.99) and gestational age at debut of preeclampsia, OR 0.97 (0.94-0.99). NICU admittance (n=31) was only predicted by gestational age at delivery, OR 0.80 (0.67-0.96). No association was found between any of the independent variables and a low umbilical artery pH (n= 10). CONCLUSIONS: In the surveillance of patients with established preeclampsia, the value of serial blood and urine sampling, which is common practice in many obstetrical units, might be questioned.

Abruptio Placentae↗
PubMed1976

Aspects of obstetrical defibrination in West Malaysia.

Five patients illustrate various aspects of obstetrical defibrination in West Malaysia, resulting from exaggeration of changes in fibrinolytic-coagulation equilibrium that occur at delivery. Hypofibrinogenaemia and fibrinolysis may occur in association or either feature predominate. These patients are from a population in which a variety of genetic and environmental factors may interact, e.g. abnormal haemoglobins, cold agglutinins, viral and other infections, introducing additional complications.

Abortion, Spontaneous↗
PubMed2000

Outcome of pregnancies subsequent to placental abruption: a risk assessment.

OBJECTIVE: To assess the risk of small for gestational age (SGA), preterm birth, pregnancy induced hypertension (PIH), and perinatal death in the pregnancy immediate subsequent to a placental abruption (PA) in the same mother. DESIGN: A cohort study based on the Medical Birth Registry of Norway. RESULTS: Odds ratios of SGA in subsequent PA- and non-PA deliveries were 2.8 (absolute risk = 18.5%) and 2.0 (13.9%), respectively, compared with non-PA deliveries without a history of previous PA among siblings (7.5%) after exclusion of cases with SGA in the immediate previous birth. After exclusion of cases with spontaneous preterm birth in the immediate previous delivery, odds ratios of spontaneous preterm birth in subsequent PA- and non-PA deliveries were 17.0 (36.3%) and 2.1 (6.6%), compared with non-PA deliveries without a history of previous PA among siblings (3.2%). After exclusion of cases with PIH in the immediate previous pregnancy, odds ratios of PIH in subsequent PA- and non-PA pregnancies were 2.9 (6.3%) and 1.6 (3.4%), compared with non-PA deliveries without a history of previous PA among siblings (2.3%). After adjustment for demographic variables and obstetrical complications, the increased risks persisted. CONCLUSION: A pregnancy following a PA must be considered a high risk pregnancy, not only in terms of excess risk of recurrence, but also due to excess risk of SGA, preterm birth, and PIH irrespective of recurrence of PA. Consequently, all pregnancies following a pregnancy with PA should be offered close antenatal surveillance and care.

Abruptio Placentae↗
PubMed2000

[Myocardial ischemia during cesarean section in a patient with placental abruption].

A 27-year-old woman (38 week pregnant) was admitted to an obstetric hospital with an acute severe abdominal pain. At that time, the fetal heart sound was not audible. The diagnosis of placental abruption was made and she underwent an emergency cesarean section (C/S) under general anesthesia. She had anemia which became worse in the first few hours after C/S, requiring blood transfusion. ST depression was also present in the ECG during this period. Subsequently, we found an increase in myocin light chain, but not in troponin-T. On the 2nd postoperative day, pulmonary edema appeared and DIC was suspected. We treated her with nitrates, diuretics, protease inhibitors and oxygen by mask. She was discharged on 14th postoperative day with no other complications. Cardiac echogram showed no abnormalities, but a borderline change was seen in her exercise ECG. Depression of the ST segment has been reported in C/S patients, but this does not indicate myocardial ischemia (MI) nor treatment is necessary in most cases. In our case, the diagnosis was not conclusive, but in view of the risks associated with MI, patients with placental abruption should be managed strictly as if they have MI.

Abruptio Placentae↗