Clinical Study on Abruptio Placentae

Park, S K; Kim, P J; Kang, S S; Eun, M H; Lee, J H; Kim, J I

Abstract

Abruptio placentae is the separation of a normally implanted placenta after the 20th week of gestation and before the birth of fetus. It is the one of third trimester obstetric hemorrhage disease that the need emergency treatment. Clinical investigation of abruptio placentae is needed for its early diagnosis and adequate treatment. This study was investigated of the 126 cases of abruptio placentae among 23,848 deliveries, which admitted to the Department of Obstetrics and Gynecology, College of Medicine, Keimyung University, during 5 years of period from January, 1992 to December, 1996. The results were as follows; 1. The incidence of abruptioplacentae was 0.53%. 2. In the timing of diagnosis, 50.8% of abruptio placentae was diagnosed before delivery. 3. Abruptio placentae occurred between 26 and 30 years old mostly. 4. The majority of abruptio placentae occurred between 33 and 37 weeks of gestational age (47.7%), and with occurred before 37 weeks was about 83.8%. 5. The incidence of unknown etiology was 56 cases (44.4%) and pregnancy induced hypertension was 48 cases (38.1%). 6. The most common symptom and sign in this study was vaginal bleeding (66.6%). Intrauterine fetal death was found in 32.5% and uterine tenderness in 25.4%. 7. As for the distribution of birth weight 33 cases (25.5%) were 1,500 to 2,000 gm and 22 case (16.9%) were 2,000 to 2,500 gm. The weight of neonates was under 2,500 gm in 74.7%. 8. Perinatal mortality and morbidity were closely related with grade of placental abruptio and gestational weeks. 9. In 56 cases (44.5%) blood transfusion was necessary. 10. The complication of abruptio placentae of this study were followed. Couvelaire uterus occurred in 15 patients, disseminated intravascular coagulation in 12 patients. The others were retinal detachment, acute renal failure, pulmonary edema. 11. Cesarean birth was performed in 43.7% and vaginal delivery in 56.3%. Fetal distr-ess was most common indication of cesarean birth. 12. Perinatal mortality rate was 51.6% including stillbirth (40.8%) and neonatal death (12.8%).