The effect of pregnancy induced hypertensive disorders on perinatal death in placental abruption

Kim, Ji Eun; Kang, Ji Young; Park, Man Chul

Abstract

OBJECTIVE
To evaluate the clinical profiles and outcomes of patients with placental abruption and the effect of hypertensive disorders on perinatal death.
METHODS
It was a retrospective study over 9 years from 1 January 1995 to 31 December 2003. We reviewed the data of women (N=104) presenting placental abruption among 10,940 women who were delivered at this hospital.
RESULTS
The incidence of placental abruption was 0.95% or one in 104 deliveries. Only 47.6% of these could be diagnosed before delivery. The most common symptom was vaginal bleeding (71.1%) and intrauterine fetal death had already occurred in 26.9%. Perinatal mortality rate was 32.6% including still birth (26.9%) and neonatal death (5.7%). There was no maternal death. 28.8% of placental abruption were associated with preeclampsia and other hypertensive disorders but in most cases (68.3%), the contributing factors could not be found. When the hypertensive disorders were associated, perinatal mortality rate was 33%, which was not significantly different when compared with perinatal mortality (32%) without hypertensive disorder (p>0.05). But the neonates from the hypertensive women were more growthly impaired than those from normotensive women (p<0.05).
CONCLUSION
Hypertensive disorders was an important factor in women with placental abruption but in most cases the contributing factors could not be found. The hypertensive disorders did not aggravate the perinatal mortality but increased the rate of intrauterine growth retardation in placental abruption.