Risk factors for perinatal mortality in patients admitted to the hospital with the diagnosis of placental abruption
| Autor: | David Blitzer, Yinka Oyelese, Jacobo L. Santolaya, Andrew L. Atkinson, Joseph Canterino, Paul G. Matta, Joaquin Santolaya-Forgas |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Separation (statistics) Logistic regression Young Adult Patient Admission Pregnancy Risk Factors Placenta medicine Humans In patient Abruptio Placentae Perinatal Mortality Fetus Placental abruption Perinatal mortality Obstetrics business.industry Infant Newborn Obstetrics and Gynecology medicine.disease Substance abuse medicine.anatomical_structure Pediatrics Perinatology and Child Health Female business |
| Zdroj: | The Journal of Maternal-Fetal & Neonatal Medicine. 28:594-597 |
| ISSN: | 1476-4954 1476-7058 |
| Popis: | Placental abruption is a clinical term used when premature separation of the placenta from the uterine wall occurs prior to delivery of the fetus. Hypertension, substance abuse, smoking, intrauterine infection and recent trauma are risk factors for placental abruption. In this study, we sought for clinical factors that increase the risk for perinatal mortality in patients admitted to the hospital with the clinical diagnosis of placental abruption.We identified all placental abruption cases managed over the past 6 years at our Center. Those with singleton pregnancies and a diagnosis of abruption based on strict clinical criteria were selected. Eleven clinical variables that had potential for increasing the risk for perinatal mortality were selected, logistic regression analysis was used to identify variables associated with perinatal death.Sixty-one patients were included in the study with 16 ending in perinatal death (26.2%). Ethnicity, maternal age, gravidity, parity, use of tobacco, use of cocaine, hypertension, asthma, diabetes, hepatitis C, sickle cell disease and abnormalities of amniotic fluid volume were not the main factors for perinatal mortality. Gestational age at delivery, birthweight and history of recent trauma were significantly associated with perinatal mortality. The perinatal mortality rate was 42% in patients who delivered prior to 30 weeks of gestation compared to 15% in patients who delivered after 30 weeks of gestation (p 0.05). A three-fold increase in severe trauma was reported in the group of patients with perinatal mortality than in the group with perinatal survivors (25% versus 7%, respectively, p 0.05).In patients admitted to hospital for placental abruption delivery prior to 30 weeks of gestation and a history of abdominal trauma are independent risk factors for perinatal death. |
| Databáze: | OpenAIRE |
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