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Erschienen in: Archives of Gynecology and Obstetrics 4/2011

01.04.2011 | Materno-fetal Medicine

Clinical significance of singleton pregnancies complicated by placental abruption occurred at preterm compared with those occurred at term

verfasst von: Shunji Suzuki, Misao Satomi, Yoshie Hiraizumi, Hidehiko Miyake

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 4/2011

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Abstract

Objective

This study investigated the clinical significance of placental abruption occurred at preterm compared with those that occurred at term.

Methods

We reviewed the obstetric records of 102 singleton deliveries complicated by placental abruption after 22 weeks of gestation. The χ2 test for categorical variables was used and differences with p < 0.05 were considered significant. Odds ratios (ORs) and 95% confidence intervals (CIs) were also calculated.

Results

Of 102 cases of placental abruption, 60 cases (59%) occurred at preterm and 42 (41%) at term. There were no significant differences in perinatal outcomes between the two groups with preterm and term gestations. The incidence of histological chorioamnionitis in the preterm group was significantly higher than that in the term group (crude OR 3.4, 95% CI 1.4–8.2, p < 0.01) while that of placental embolisms and/or infarctions in the preterm group was significantly lower than that in the term group (crude OR 0.35, 95% CI 0.16–0.80, p = 0.01). Using logistic regression, preterm placental abruption was significantly more likely in multiparous patients (adjusted OR 2.5, 95% CI 1.0–6.2, p = 0.046) and those demonstrating histological chorioamnionitis (adjusted OR 3.5, 95% CI 1.4–9.1, p < 0.01), while term placental abruption was significantly more likely in cases of placental embolisms and/or infarctions (adjusted OR 3.5, 95% CI 1.2–10, p = 0.02).

Conclusion

The current results indicate that the possible processes leading to placental abruption at preterm are different from those at term.
Literatur
1.
Zurück zum Zitat Ananth CV, Getahun D, Peltier MR, Smulian JC (2006) Placental abruption in term and preterm gestations. Obstet Gynecol 107:785–792PubMedCrossRef Ananth CV, Getahun D, Peltier MR, Smulian JC (2006) Placental abruption in term and preterm gestations. Obstet Gynecol 107:785–792PubMedCrossRef
2.
Zurück zum Zitat Benirschke K, Kaufmann P, Baergen RN (2006) Infarcts. In: Benirschke K, Kaufmann P, Baergen RN (eds) Pathology of the human placenta, 5th edn. Springer, New York, pp 612–615 Benirschke K, Kaufmann P, Baergen RN (2006) Infarcts. In: Benirschke K, Kaufmann P, Baergen RN (eds) Pathology of the human placenta, 5th edn. Springer, New York, pp 612–615
3.
Zurück zum Zitat Benirschke K, Kaufmann P, Baergen RN (2006) Chorioamnionitis. In: Benirschke K, Kaufmann P, Baergen RN (eds) Pathology of the human placenta, 5th edn. Springer, New York, pp 657–694 Benirschke K, Kaufmann P, Baergen RN (2006) Chorioamnionitis. In: Benirschke K, Kaufmann P, Baergen RN (eds) Pathology of the human placenta, 5th edn. Springer, New York, pp 657–694
4.
Zurück zum Zitat Blanc WA (1959) Amniotic infection syndrome: pathogenesis morphology, and significance in circumnatal mortality. Clin Obstet Gynecol 2:705–734CrossRef Blanc WA (1959) Amniotic infection syndrome: pathogenesis morphology, and significance in circumnatal mortality. Clin Obstet Gynecol 2:705–734CrossRef
5.
Zurück zum Zitat Dong Y, St Clair PJ, Ramzy I, Kagen-Hallet KS, Gibbs RS (1987) A microbiologic and clinical study of placental inflammation at term. Obstet Gynecol 70:175–182PubMed Dong Y, St Clair PJ, Ramzy I, Kagen-Hallet KS, Gibbs RS (1987) A microbiologic and clinical study of placental inflammation at term. Obstet Gynecol 70:175–182PubMed
6.
Zurück zum Zitat Elliott JP, Gilpin B, Strong TH Jr, Finberg HJ (1998) Chronic abruption—oligohydramnios sequence. J Reprod Med 43:418–422PubMed Elliott JP, Gilpin B, Strong TH Jr, Finberg HJ (1998) Chronic abruption—oligohydramnios sequence. J Reprod Med 43:418–422PubMed
7.
Zurück zum Zitat Gibbs RS, Romero R, Hiller SL, Eschenbach DA, Sweet RL (1992) A review of premature birth and subclinical infection. Am J Obstet Gynecol 166:1515–1528PubMed Gibbs RS, Romero R, Hiller SL, Eschenbach DA, Sweet RL (1992) A review of premature birth and subclinical infection. Am J Obstet Gynecol 166:1515–1528PubMed
8.
Zurück zum Zitat Harris BA Jr, Gore H, Flowers CE Jr (1985) Peripheral placental separation: a possible relationship to premature labor. Obstet Gynecol 66:774–778PubMed Harris BA Jr, Gore H, Flowers CE Jr (1985) Peripheral placental separation: a possible relationship to premature labor. Obstet Gynecol 66:774–778PubMed
9.
Zurück zum Zitat Harris BA Jr (1988) Peripheral placental separation: a review. Obstet Gynecol Surv 43:577–581PubMedCrossRef Harris BA Jr (1988) Peripheral placental separation: a review. Obstet Gynecol Surv 43:577–581PubMedCrossRef
10.
Zurück zum Zitat Hibbard BM, Hibbard ED (1963) Aetiological factors in abruption placentae. Part 1: epidemiology. BMJ 2:1430–1432PubMedCrossRef Hibbard BM, Hibbard ED (1963) Aetiological factors in abruption placentae. Part 1: epidemiology. BMJ 2:1430–1432PubMedCrossRef
11.
Zurück zum Zitat Hillier SL, Martius J, Krohn M, Kiviat N, Holmes KK, Eschenbach DA (1988) A case-control study of chorioamnionic infection and histologic chorioamnionitis in prematurity. N Engl J Med 319:912–918CrossRef Hillier SL, Martius J, Krohn M, Kiviat N, Holmes KK, Eschenbach DA (1988) A case-control study of chorioamnionic infection and histologic chorioamnionitis in prematurity. N Engl J Med 319:912–918CrossRef
12.
Zurück zum Zitat Koifman A, Levy A, Zaulan Y, Harlev A, Mazor M, Wiznitzer A, Sheiner E (2008) The clinical significance of bleeding during the second trimester of pregnancy. Arch Gynecol Obstet 278:47–51PubMedCrossRef Koifman A, Levy A, Zaulan Y, Harlev A, Mazor M, Wiznitzer A, Sheiner E (2008) The clinical significance of bleeding during the second trimester of pregnancy. Arch Gynecol Obstet 278:47–51PubMedCrossRef
13.
Zurück zum Zitat Nath CA, Ananth CV, Smulian JC, Shen-Schwarz S, Kaminsky L (2007) Histologic evidence of inflammation and risk of placental abruption. Am J Obstet Gynecol 197:319.e1–319.e6CrossRef Nath CA, Ananth CV, Smulian JC, Shen-Schwarz S, Kaminsky L (2007) Histologic evidence of inflammation and risk of placental abruption. Am J Obstet Gynecol 197:319.e1–319.e6CrossRef
14.
Zurück zum Zitat Ogawa Y, Iwamura T, Kuriya N, Nishida H, Takeuchi H, Takada M, Itabashi K, Imura S, Isobe K (1998) Birth size standards by gestational age for Japanese neonates (in Japanese). Acta Neonatol Jpn 34:624–632 Ogawa Y, Iwamura T, Kuriya N, Nishida H, Takeuchi H, Takada M, Itabashi K, Imura S, Isobe K (1998) Birth size standards by gestational age for Japanese neonates (in Japanese). Acta Neonatol Jpn 34:624–632
15.
Zurück zum Zitat Page EW, King EB, Merill JA (1954) Abruptio placentae: danger of delivery. Obstet Gynecol 3:385–393PubMed Page EW, King EB, Merill JA (1954) Abruptio placentae: danger of delivery. Obstet Gynecol 3:385–393PubMed
16.
Zurück zum Zitat Paterson ME (1979) The aetiology and outcome of abruption placentae. Acta Obstet Gynecol Scand 58:31–35PubMedCrossRef Paterson ME (1979) The aetiology and outcome of abruption placentae. Acta Obstet Gynecol Scand 58:31–35PubMedCrossRef
17.
Zurück zum Zitat Rana A, Sawhney H, Gopalan S, Penigrahi D, Nijhawan R (1999) Abruptio placentae and chorioamnionitis-microbial and histological correlation. Acta Obstet Gynecol Scand 78:363–366PubMedCrossRef Rana A, Sawhney H, Gopalan S, Penigrahi D, Nijhawan R (1999) Abruptio placentae and chorioamnionitis-microbial and histological correlation. Acta Obstet Gynecol Scand 78:363–366PubMedCrossRef
18.
Zurück zum Zitat Sheiner E, Shoham-Vordi I, Hadar A, Hallak M, Hackman R, Mazor M (2002) Incidence, obstetric risk factors and pregnancy outcome of preterm placental abruption: a retrospective analysis. J Matern Fetal Neonatal Med 11:34–39PubMed Sheiner E, Shoham-Vordi I, Hadar A, Hallak M, Hackman R, Mazor M (2002) Incidence, obstetric risk factors and pregnancy outcome of preterm placental abruption: a retrospective analysis. J Matern Fetal Neonatal Med 11:34–39PubMed
19.
Zurück zum Zitat Sheiner E, Shoham-Vordi I, Hadar A, Hallak M, Hackman R, Mazor M (2003) Placental abruption in term pregnancies: clinical significance and obstetric risk factors. J Matern Fetal Neonatal Med 13:45–49PubMed Sheiner E, Shoham-Vordi I, Hadar A, Hallak M, Hackman R, Mazor M (2003) Placental abruption in term pregnancies: clinical significance and obstetric risk factors. J Matern Fetal Neonatal Med 13:45–49PubMed
20.
Zurück zum Zitat Suzuki S (2008) Clinical significance of pregnancies with circumvallate placenta. J Obstet Gynaecol Res 34:51–54PubMed Suzuki S (2008) Clinical significance of pregnancies with circumvallate placenta. J Obstet Gynaecol Res 34:51–54PubMed
21.
Zurück zum Zitat Usui R, Matsubara S, Ohkuchi A, Kuwata T, Watanabe T, Izumi A, Suzuki M (2008) Fetal heart rate pattern reflecting the severity of placental abruption. Arch Gynecol Obstet 277:249–253PubMedCrossRef Usui R, Matsubara S, Ohkuchi A, Kuwata T, Watanabe T, Izumi A, Suzuki M (2008) Fetal heart rate pattern reflecting the severity of placental abruption. Arch Gynecol Obstet 277:249–253PubMedCrossRef
22.
Zurück zum Zitat Vintzileous AM, Campbell WA, Nochimson DJ, Weinbaum PJ (1987) Preterm premature rupture of the membranes: a risk factor for the development of abruptio placentae. Am J Obstet Gynecol 156:1235–1238 Vintzileous AM, Campbell WA, Nochimson DJ, Weinbaum PJ (1987) Preterm premature rupture of the membranes: a risk factor for the development of abruptio placentae. Am J Obstet Gynecol 156:1235–1238
23.
Zurück zum Zitat Williams MA, Lieberman E, Mittendorf R, Monson RR, Schoenbaum SC (1991) Risk factors for abruptio placentae. Am J Epidemiol 134:965–972PubMed Williams MA, Lieberman E, Mittendorf R, Monson RR, Schoenbaum SC (1991) Risk factors for abruptio placentae. Am J Epidemiol 134:965–972PubMed
Metadaten
Titel
Clinical significance of singleton pregnancies complicated by placental abruption occurred at preterm compared with those occurred at term
verfasst von
Shunji Suzuki
Misao Satomi
Yoshie Hiraizumi
Hidehiko Miyake
Publikationsdatum
01.04.2011
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 4/2011
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-010-1478-1

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