Placental abruption: epidemiology, risk factors and consequences

Abstract

Placental abruption, classically defined as a premature separation of the placenta before delivery, is one of the leading causes of vaginal bleeding in the second half of pregnancy. Approximately 0.4-1% of pregnancies are complicated by placental abruption. The prevalence is lower in the Nordic countries (0.38-0.51%) compared with the USA (0.6-1.0%). Placental abruption is also one of the most important causes of maternal morbidity and perinatal mortality. Maternal risks include obstetric hemorrhage, need for blood transfusions, emergency hysterectomy, disseminated intravascular coagulopathy and renal failure. Maternal death is rare but seven times higher than the overall maternal mortality rate. Perinatal consequences include low birthweight, preterm delivery, asphyxia, stillbirth and perinatal death. In developed countries, approximately 10% of all preterm births and 10-20% of all perinatal deaths are caused by placental abruption. In many countries, the rate of placental abruption has been increasing. Although several risk factors are known, the etiopathogenesis of placental abruption is multifactorial and not well understood.

Effect of morphological and functional changes in the secundines on biometric parameters of newborns from dichorionic twin pregnancies

“…The exact mechanism defining how ascending infection stimulates preterm delivery is still unclear; overproduction of cytokines by activated macrophages was postulated to enhance the synthesis of prostaglandins which act as a direct trigger to initiate labor [28][29][30][31]. Perinatal consequences of ascending infection may also include low birth weight, stillbirth or intrauterine death [14,32]. Our findings confirm that placental inflammation is associated both with a decrease in biometric parameters of the neonate and with higher incidence of preterm birth and stillbirth.…”

“…Placental abruption is considered to be a significant independent predictor of preterm birth [14,[32][33][34][35]. Ananth et al [14] showed that placental abruption is associated with a 4-to 6-fold increase in the risk of preterm birth.…”

Antepartum and Intrapartum Factors Preceding Neonatal Hypoxic-Ischemic Encephalopathy

“…The relation between maternal age, parity, previous obstetric history, fetal growth, and other maternal conditions with intrapartum complications such as sentinel events or abnormal CTG has previously been explored. [26][27][28][29] In Locatelli et al used inclusion and exclusion criteria similar to ours in a hospitalbased study of 27 cases and 100 term controls. Intrapartum factors alone were found in 22% of cases and a combination of antepartum and intrapartum factors was identified in an additional 44%.…”

Q36R (rs 35431622) Polymorphism in KISS1 Gene and Idiopathic Female Infertility in a Northern Iranian Population

“…Usually, the duration of infertility is more than twelve months (1). The rate of unexplained infertility varies in different cases and studies but is usually about 10 to 20% (2,3). Unexplained infertility is not an immovable condition, it is a relative inability to conceive, and it is clear that many of these couples may conceive without treatment, but treatment will often fasten the time to conceive (4).…”