Vaginal delivery after placental abruption with intrauterine fetal death: a 20-year single-center experience
Abstract
Abstract Aim The aim of this study was to elucidate the feasibility and safety of vaginal delivery (VD) when placental abruption causes fetal demise. Methods We conducted a retrospective study of women who were managed for placental abruption with intrauterine fetal death at Kyoto University Hospital during the period from 1995 to 2015. Results Sixteen cases were identified during the study period. VD was attempted in 15 cases and was accomplished in 14 (93.3%) cases. The median gestational age was 36 (24–39) weeks, and there were eight primiparas. The median Bishop score on admission was 2.5 (1–9). Eight pregnancies were complicated with pregnancy‐induced hypertension. The median duration of labor was 5 h and 18 min (30 min–12 h 43 min), and the median amount of hemorrhage was 2503 (445–6808) mL. Fresh frozen plasma (≥ 20 U) and red cell concentrate (≥ 10 U) were administered in 10 (71%) and 9 (64%) cases, respectively. Two cases required uterine artery embolization for post‐partum hemorrhage, while there was no case of maternal death or hysterectomy. Patients with Bishop score > 3 (n = 6) experienced shorter‐duration deliveries (P = 0.020) and had significantly larger blood loss volume (P = 0.020) compared to patients with Bishop score ≤ 3. The duration of labor was negatively correlated with the amount of blood loss (R2 = −0.56, P = 0.039). Conclusion After placental abruption with intrauterine fetal death, VD is feasible and safe regardless of gestational age, parity, cervical maturity, and duration of labor when intensive medical resources are available.
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Among fetal deaths associated with abruption, patients with Bishop scores >3 had larger blood loss than those with Bishop scores ≤3 (3605 cc versus 1788 cc).
“Patients with Bishop scores >3 had shorter labors (3:37 hours versus 7:58 hours) and larger blood loss (3605 cc versus 1788 cc) compared to patients with Bishop scores ≤3 (109)”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [109]
Among fetal deaths associated with abruption, patients with Bishop scores >3 had shorter labors than those with Bishop scores ≤3 (3:37 hours versus 7:58 hours).
“Patients with Bishop scores >3 had shorter labors (3:37 hours versus 7:58 hours) and larger blood loss (3605 cc versus 1788 cc) compared to patients with Bishop scores ≤3 (109)”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [109]
In a single-center retrospective cohort study of fetal deaths associated with abruption from 1995-2015, vaginal delivery was successful in 14 of 15 (93.3%) cases that underwent trial of labor.
“In a single center retrospective cohort study of fetal deaths associated with abruption (1995–2015), vaginal delivery was successful in 14 of 15 (93.3%) cases that underwent trial of labor.”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [109]
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Brandt, J. S., & Ananth, C. V. (2023) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.06.059 · Cited by 115 · see citing works
- Authors
- Inoue, A., Kondoh, E., Suginami, K., Io, S., Chigusa, Y., & Konishi, I.
- Affiliations
- Kyoto University (JP)
- Corresponding author
- Kondoh, Eiji
- Venue
- Journal of obstetrics and gynaecology research
- Publisher
- Wiley
- Published
- 2017-03-28
- Volume
- 43
- Issue
- 4
- Pages
- 676-681
- ISSN
- 1341-8076 (ISSN-L)
- 1447-0756
- OpenAlex
- W2748235017
- Cited by
- 11
- References
- 10
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 5 · 2022: 2 · 2021: 1 · 2018: 1
- FWCI
- 0.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of obstetrics and gynaecology research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- vaginal delivery, placental abruption, intrauterine fetal death, Bishop score, cervical maturity, duration of labor, postpartum hemorrhage, uterine artery embolization, blood loss, gestational hypertension, maternal safety
- MeSH terms
- Abruptio Placentae, Adult, Female, Fetal Death, Humans, Pregnancy, Outcome Assessment, Health Care, Delivery, Obstetric, Young Adult
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