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Cited by 131Maternal and fetal healthcarePregnancy and preeclampsia studiesMaternal and Perinatal Health Interventions

Pregnancy outcome in severe placental abruption

Kayani, Salma Imran, Walkinshaw, Stephen A., Preston, Carrol·2003·BJOG: An International Journal of Obstetrics & Gynaecology
DOI 10.1046/j.1471-0528.2003.02088.x
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Abstract

OBJECTIVE: To determine the relationship between decision to delivery interval and perinatal outcome in severe placental abruption. DESIGN: A case-control study. SETTING: Large inner city teaching hospital. METHODS: Retrospective case note review of pregnancies terminated following severe placental aburption and fetal bradycardia. One year paediatric follow up by case note review or postal questionnaire. The differences in outcome (death or cerebral palsy) were examined using non-parametric and univariate analysis for the following time periods--times from onset of symptoms to delivery, onset of symptoms to admission, admission to delivery, onset bradycardia to delivery and decision to delivery interval. MAIN OUTCOME MEASURES: Prenatal death or survival with cerebral palsy. RESULTS: Thirty-three women with singleton pregnancies over 28 weeks of gestation, admitted with clinically overt placental abruption, where delivery was effected for fetal bradycardia. Eleven of the pregnancies had a poor outcome (cases), eight infants died and three surviving infants have cerebral palsy. Twenty-two pregnancies had a good outcome (controls): survival with no developmental delay. No statistically significant relationship was found between maternal age, parity, gestation, or birthweight and a poor outcome. A statistically significant relationship between time from decision to delivery was identified (P = 0.02, Mann-Whitney U test). The results of a univariate logistic regression for this variable suggest that the odds ratio of a poor outcome for delivery at 20 minutes compared with 30 minutes is 0.44 (95% CI 0.22-0.86). Fifty-five percent of infants were delivered within 20 minutes of the decision to deliver. Serious maternal morbidity was rare. CONCLUSION: In this small study of severe placental abruption complicated by fetal bradycardia, a decision to delivery interval of 20 minutes or less was associated with substantially reduced neonatal morbidity and mortality.

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Authors
Kayani, S. I., Walkinshaw, S. A., & Preston, C.
Affiliations
Liverpool Women's Hospital (GB)
Corresponding author
Walkinshaw, Stephen A.
ORCID
Kayani, Salma Imran
Venue
BJOG: An International Journal of Obstetrics & Gynaecology
Publisher
Wiley
Published
2003-07
Volume
110
Issue
7
Pages
679-683
ISSN
  • 0306-5456 (ISSN-L)
  • 1470-0328
  • 1471-0528
DOI
10.1046/j.1471-0528.2003.02088.x
OpenAlex
W2077905327
Cited by
131
References
22
Citations by year
2025: 5 · 2024: 4 · 2023: 5 · 2022: 10 · 2021: 5 · 2020: 4 · 2019: 7 · 2018: 7 · 2017: 10 · 2016: 8 · 2015: 4 · 2014: 7 · 2013: 5 · 2012: 14
FWCI
3.27
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 174 d)
Locations
  • BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
placental abruption, fetal bradycardia, delivery interval, perinatal outcomes, neonatal mortality, cerebral palsy, neonatal morbidity, delivery time, maternal morbidity
MeSH terms
Abortion, Induced, Abruptio Placentae, Adult, Bradycardia, Decision Making, Female, Fetal Diseases, Gestational Age, Heart Rate, Fetal, Humans, Parity, Pregnancy, Pregnancy Outcome, Regression Analysis, Retrospective Studies, Odds Ratio, Case-Control Studies

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