The premature separation of the normaly implanted placenta from its attachment to the uterus after 20 weeks of gestation is called abruptio placentae. It is the one of third trimester obstetric hemorrhagic disease that need emergen treatment.
Bleeding and uteroplacental insufficiency caused by placental abruption affect to mother as well as fetus that result in maternal and fetal death in severe case. Clinical investigation of abruptio placentae is needed for its early diagnosis and
adequate
treatment.
The data presented here are based on 103 cases of abruptio placentae among 18, 199 deliveries at the Department of Obstetrics and Gynecology, Kyunghee university in seoul, from January 1, 1985 to December 31, 1994. @ES The results of this study
were
followed.
@EN The incidence of abruptio placentae was 0.57% of one in 176 deliveries.
2) Abruptio placentae occured between 26 and 30 years old mostly, and more in multigravida(53.4%).
3) The majority of abruptio placentae occured between 33 and 37 weeks of gestational age(42.7%), and which occured before 37 weeks was about 65%.
4) 51.5% of patients with abruptio placentae was diagnosed after delivery and 48.5% before delivery.
5) Abruptio placentae was associated with preeclampsia and other hypertensive disorders in 38.8% and unknown causes in 54.4%.
6) The most common symptom in this study was vaginal bleeding(57.3%). Abdominal pain and tenderness was found in 40.8% and intrauterine fetal death in 29.1%.
7) Perinatal mortality and morbidity were closely related with grade of placental abruption and gestational weeks.
8) The weight of neonates was under 2,500 gm in 72.8%.
9) The complication of abruptio placentae of this study were followed. Acute anemia occured in 44 patients, uteroplacental apoplexy in 15 patients, disseminated intravascular coagulation in 13 patients. The others were retinal detachment,
uterine
atony, acute renal failure, pulmonary edema, hypertensive encephalopathy and urticaria.
10) Cesarean section was performed in 52.4% and vaginal delivery in 47.6%. Fetal distress was most common indication of cesarean section.
11) Perinatal mortlaity was 39.8% including stillbirth(36.9%) and neonatal death(2.9%).
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