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Results for “ABRUPTIO PLACENTAE”

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PubMed1999

[Pregnancy induced hypertension complicated acute disseminated intravascular coagulation: clinical analysis of 26 cases].

OBJECTIVE: To determine the relationship between pregnancy induced hypertension (PIH) and acute disseminated intravascular coagulation (DIC). METHODS: 26 cases with PIH complicated acute DIC were analyzed retrospectively in five hospitals of Xi'an from 1980 to 1997. RESULTS: (1) In 26 patients with PIH complicated acute DIC, 7 cases died (26.92%), while 17 neonates died (58.62%) in 29 neonates (3 cases were twin pregnancy). Cesarean section and hysterectomy were performed on 7 cases respectively, including 4 cases underwent both of them. (2) The causative factors of PIH complicated acute DIC included placental abruption (7 cases), amniotic fluid embolism (4 cases), eclamptic seizure (4 cases), surgical injury (7 cases) and bleeding (4 cases). 7 cases induced by placental abruption were all cured, 4 cases induced by amniotic fluid embolism all died. CONCLUSION: There are close relationship between PIH and DIC, PIH complicated acute DIC is the major cause of maternal and perinatal mortality, special attention should be paid on preventing DIC for PIH.

Abruptio Placentae↗
PubMed2001

[Incidence of pregnancy induced hypertension and the effects on mother and fetus in Shanghai during 1989-1998].

OBJECTIVE: To investigate the incidence of pregnancy induced hypertension (PIH) in Shanghai during 1989-1998. METHODS: The data were analyzed retrospectively from three municipal general hospitals and five special hospitals obstetrics and gynecology. RESULTS: There were 158,790 deliveries in ten years. The total numbers of PIH were 8,852 cases. The incidence of PIH was 5.57%. The rate of mild, moderate and severe PIH was 55.83%, 29.39%, and 14.78% respectively. There were 114 cases (1.29%) complicated with eclampsia. The rate of cesarean section was 66.97% in PIH patients. The complications of PIH were as following: abruptio of Placenta 0.52%, heart failure 0.34%, renal failure 0.20%, DIC 0.07% hemolysis, elevated liver enzymes and low platelet count(HELLP) syndrome 0.03%, maternal death one case. There were 9,197 birth of 8,852 cases of PIH (twin 343 cases, triplets one cases). The perinatal death 66 occurred in cases (7.18@1000) in which fetal death 48 cases, stillbirth 12 and neonatal death 6. CONCLUSION: The incidence of PIH and the rate of perinatal infant death can be reduced by strengthen antenatal monitoring, prevention, early diagnosis and treatment of PIH.

China↗
PubMed1975

Fetal lung and kidney maturation in abnormal pregnancies.

A variety of gestational factors have been reported to increase or decrease the incidence of hyaline membrane disease in newborn infants. The purpose of the current study was to determine if some of these factors influence the rate at which fetal lung structures mature. Histologic measures of lung maturation were retarded in some infants with Rh erythroblastosis and in some whose mothers had diabetes mellitus. By contrast, such maturation was accelerated in offspring of some toxemic gestations and in those whose membranes had ruptured before the onset of labor. Congenital bacterial pneumonia with intact membranes did not accelerate maturation. None of the factors that altered lung maturity influenced renal maturation.

Abruptio Placentae↗
PubMed2003

Differences in perinatal mortality and suboptimal care between 10 European regions: results of an international audit.

OBJECTIVE: A European concerted action (the EuroNatal study) investigated the background of differences in perinatal mortality between countries of Europe. The study aimed to determine the contribution of differences in quality of care, by looking at differences in the presence of suboptimal factors in individual cases of perinatal death. DESIGN: Retrospective audit study. SETTING: Regions of 10 European countries. POPULATION: 1619 cases of perinatal death. METHODS: Perinatal deaths between 1993 and 1998 in regions of 10 European countries were identified. Reviewed were singleton fetal deaths (28 or more weeks of gestational age), intrapartum deaths (28 or more weeks) and neonatal deaths (34 or more weeks). Deaths with (major) congenital anomalies were excluded. Cases were blinded for region and an international audit panel reviewed them using explicit audit criteria. MAIN OUTCOME MEASURES: Presence of suboptimal factors. RESULTS: The audit covered 1619 cases of perinatal death, representing 90% of eligible cases in the regions. Consensus was reached on 1543 (95%) cases. In 715 (46%) of these cases, suboptimal factors, which possibly or probably had contributed to the fatal outcome, were identified. The percentage of cases with such suboptimal care factors was significantly lower in the Finnish and Swedish regions compared with the remaining regions of Spain, the Netherlands, Scotland, Belgium, Denmark, Norway, Greece and England. Failure to detect severe IUGR (10% of all cases) and smoking in combination with severe IUGR and/or placental abruption (12%) was the most frequent suboptimal factor. There was a positive association between the proportion of cases with suboptimal factors and the overall perinatal mortality rate in the regions. CONCLUSIONS: The findings of this international audit suggest that differences exist between the regions of the 10 European countries in the quality of antenatal, intrapartum and neonatal care, and that these differences contribute to the explanation of differences in perinatal mortality between these countries. The background to these differences in quality of care needs further investigation.

Abruptio Placentae↗
PubMed2003

Factor V Leiden in pregnancies complicated by placental abruption.

OBJECTIVE: Recent studies suggest an increased prevalence of obstetric complications in female carriers of hereditary or acquired thrombophilias. The aim of the study was to determine if carriership of the factor V (FV) Leiden mutation (activated protein C [APC] resistance) is higher in women who have had of placental abruption during pregnancy. DESIGN: A retrospective case-control study. SETTING: University Hospital MAS, Malmö, Sweden. METHODS: A comparison of 102 women with placental abruption with 2371 prospectively collected controls. Carriership of FV Leiden was determined and the women were interviewed. MAIN OUTCOME MEASURES: Proportion of FV Leiden carriership, first degree heritage of thrombosis and previous placental abruption in cases and controls. RESULTS: Carriage of FV Leiden was found in 15.7% of women who have had placental abruption as compared with 10.8% of controls (P = 0.12, odds ratio [OR] = 1.5, 95% confidence interval [CI] = 0.9-2.7). Around 20% of women with placental abruption reported first degree heritage for venous thrombosis, as compared with 6.7% of controls (P < or = 0.001). CONCLUSIONS: FV Leiden carriership was not significantly different in women with placental abruption. However, there was an increased prevalence of first degree heritage for venous thrombosis in women with placental abruption, indicating a higher prevalence of thrombophilia among women with placental abruption.

Abruptio Placentae↗
PubMed2003

Pregnancy outcome in severe placental abruption.

OBJECTIVE: To determine the relationship between decision to delivery interval and perinatal outcome in severe placental abruption. DESIGN: A case-control study. SETTING: Large inner city teaching hospital. METHODS: Retrospective case note review of pregnancies terminated following severe placental aburption and fetal bradycardia. One year paediatric follow up by case note review or postal questionnaire. The differences in outcome (death or cerebral palsy) were examined using non-parametric and univariate analysis for the following time periods--times from onset of symptoms to delivery, onset of symptoms to admission, admission to delivery, onset bradycardia to delivery and decision to delivery interval. MAIN OUTCOME MEASURES: Prenatal death or survival with cerebral palsy. RESULTS: Thirty-three women with singleton pregnancies over 28 weeks of gestation, admitted with clinically overt placental abruption, where delivery was effected for fetal bradycardia. Eleven of the pregnancies had a poor outcome (cases), eight infants died and three surviving infants have cerebral palsy. Twenty-two pregnancies had a good outcome (controls): survival with no developmental delay. No statistically significant relationship was found between maternal age, parity, gestation, or birthweight and a poor outcome. A statistically significant relationship between time from decision to delivery was identified (P = 0.02, Mann-Whitney U test). The results of a univariate logistic regression for this variable suggest that the odds ratio of a poor outcome for delivery at 20 minutes compared with 30 minutes is 0.44 (95% CI 0.22-0.86). Fifty-five percent of infants were delivered within 20 minutes of the decision to deliver. Serious maternal morbidity was rare. CONCLUSION: In this small study of severe placental abruption complicated by fetal bradycardia, a decision to delivery interval of 20 minutes or less was associated with substantially reduced neonatal morbidity and mortality.

Abortion, Induced↗