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KMID : 0358420080510101085
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Korean Journal of Obstetrics and Gynecology
2008 Volume.51 No. 10 p.1085 ~ p.1093
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Clinical study on obstetric variables affecting perinatal mortality in placental abruption
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Jung Hee-Jung
Jung En-Ha
Lee Kyung
Jung Hee-Ra
Kim Myung-Hwan
Ko Ji-Kyung
Cho Yong-Kyoon
Choi Hoon
Kim Bok-Rin
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Abstract
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Objective: To evaluate obstetric variables in the placental abruption that affect on perinatal mortality.
Methods: We reviewed clinical data of all singleton deliveries complicated with placental abruption between January 2000 and December 2007, in Department of Ob. & Gyn., Sanggye Paik Hospital.
Results: Placental abruption complicated 54 cases (0.55%) of all deliveries (n=9,903) from January 2000 to December 2007. The peak age was 26-30 years (42.1%). The most common symptom was vaginal bleeding (57.4%) and intrauterine fetal death had already occurred in 9.3%. Perinatal mortality rate was 13.0% and there was no maternal death. 38.9% of placental abruption occurred between 33 to 36weeks of gestational age. 38.9% of placental abruption was diagnosed before delivery with ultrasonography and 9.3% was chronic placental abruption. 33.3% of placental abruption was associated with preeclampsia, and then associated with PPROM (24.1%), uterine myoma (3.7%), chronic hypertension (1.9%) and smoking (1.9%). When the hypertensive disorders were associated, fetal distress rate was higher
than normotensive pregnancy (63.2% vs 20.0%, P-value: 0.005). Mean gestational age (days) (194±32.8 vs 248.12±28.0, P-value<0.001) and the severity of placental abruption (P-value: 0.005) affect perinatal mortality in placental abruption. The most common complication of placental abruption was DIC (16 cases, 29.6%), followed by Couvelaire uterus (4 cases, 7.4%) and uterine rupture (1 case, 1.9%).
Conclusion: Obstetric variables that affect perinatal mortality were gestational age at the diagnosis and the severity of placental abruption.
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KEYWORD
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Placental abruption, Hypertension, Perinatal mortality
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