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KMID : 0358419700130080003
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Korean Journal of Obstetrics and Gynecology
1970 Volume.13 No. 8 p.3 ~ p.9
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Abruptio Placentae, 6 years Review ( 1963 - 1968 )
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강신명/Kang SM
김수자/이경자/이일준/Kim SJ/Lee KZ/Rhee IJ
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Abstract
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Abruptio placenta is a serious complication in pregnancy when dealing with maternal death as well as fetal loss especially in the country having high incidence of toxemia. 1. We have encountered 34 cases of Abruptio placentae which occured among a total of 10,640 deliveries in Ewha Womens University Hospital, Seoul during the period of 6 years from 1963 to 1968, the incidence being one case per 330 deliveries or 0.32%. Although this incidence was considered relativity low both the maternal & fetal death rate were markdly high. 2. The leading causative predisposing factor of the abruptio pladentae in this series was toxemia occupying one-third(38%) of the cases. The other known cause was shortness of the umbilical cord(26%) including it`s strangulation. Indeed every efforts to prevent the toxemias of pregnancy are important at present among the numerous caucative factors. 3. The majority of placentae occured between age of 30&40, and more in multigravidas(88%). It was interesting to notice that more than one-half(56%) of the cases of abruptio placentae had a tendency of prematurity occuring from 27 to 37 weeks of gestation period. 4. Abruptio placentae with concealed hemorrhage was serious in it`s nature. However the fetal death rate were considered to be high(80%) even in the mild group which probably due to the delayed admission from the patient side. 5. The average amount of blood transfusion needed was 3 pints in the mild cases, and 6 pints or more in the severe cases. 6. About one-half(56%) of the abruptio placentae were treated by Cesarean section mostly for the severe cases with shock or for the fetal distress. The perinatal mortality was reduced to 53% in these section group. 7. The incidence of prenatal care undergone was very low(only 18%). Both quantative and qualitive prenatal care would be important to prevent abruptio placentae, and it should be warn if any toxemic state or sudden pain develops in multigravidas, over 30 year of age, particularly during 27-37 weeks of gestation. 8. The prognosis of the patient with abruptio placentae admitted in 4 hours after it`s onset was much fair than the delayed in which revealing the partial or less than one-half area of the placental detatchment with some hopeful(25%) fatal salvage. Therefore the abruptio placentae should be terminated promptly in 2~4~8 hours after the accident has occurred.
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