Clinical utility of sonography in the diagnosis and treatment of placental abruption
Abstract
OBJECTIVE: To determine the sensitivity and specificity of sonography for detection of placental abruption and whether sonographic results correlate with management or outcome. METHODS: We identified 149 consecutive patients who underwent sonography at 24 weeks' gestational age or later for ruling out abruption or vaginal bleeding. Obstetric and neonatal data were obtained from the hospital perinatal database. Sonographic results, pathologic reports, and hospital charts were reviewed. Sonographic sensitivity, specificity, and positive and negative predictive values were calculated, and regression was used to determine independence of associations. RESULTS: Of the 149 patients, 17 (11%) had sonographic evidence of abruption, and 32 (21%) had evidence of abruption at delivery. As the scan-to-delivery interval decreased, the positive predictive value increased and the negative predictive value decreased. Of 55 patients who gave birth within 14 days of sonography, 8 (15%) had scans consistent with abruption, and 29 (53%) had abruption at delivery; the sensitivity, specificity, and positive and negative predictive values of sonography were 24%, 96%, 88%, and 53%, respectively. Positive sonographic findings were univariately associated with 2- to 3-fold greater subsequent tocolysis, betamethasone use, duration of hospitalization, follow-up sonograms, preterm delivery, low birth weight, and neonatal intensive care unit admission. All but low birth weight and neonatal intensive care unit admission remained independently significant after adjustment for gestational age (P < .05). CONCLUSIONS: Sonography is not sensitive for detection of placental abruption, but a positive finding is associated with more aggressive management and worse neonatal outcome.
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Placental abruption is a serious complication of pregnancy that contributes to both maternal and infant morbidity and mortality.
“It is a serious complication of pregnancy that contributes to both maternal and infant morbidity and mortality [2,3].”
From Automated placental abruption identification using semantic segmentation, quantitative features, SVM, ensemble and multi-path CNN (2023) · cites this paper as [3]
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Sananès, N., Boisramé, T., & Langer, B. (2012) · EMC - Obstétrique · doi:10.1016/s0246-0335(12)50196-1 · Cited by 3 · see citing works
Imaging of Trauma in Pregnancy
Odedra, D., Mellnick, V. M., & Patlas, M. N. (2022) · Radiologic Clinics of North America · doi:10.1016/j.rcl.2022.07.006 · Cited by 3 · see citing works
Trauma in Pregnancy: A Clinical Update for Obstetrician-Gynecologists
Narvaez, J., & Vrees, R. (2021) · Topics in Obstetrics & Gynecology · doi:10.1097/01.pgo.0000753172.54103.b3 · Cited by 3 · see citing works
Augustin, G. (2023) · Springer eBooks · doi:10.1007/978-3-031-26021-6_25 · Cited by 3 · see citing works
Induction and Augmentation of Labor
Goldberg, A. (2017) · Cambridge University Press eBooks · doi:10.1017/9781316662571.004 · Cited by 3 · see citing works
MR of Obstetric Diseases in Pregnancy
Khandelwal, A., & Shanbhogue, K. (2015) · Springer eBooks · doi:10.1007/978-3-319-21428-3_19 · Cited by 3 · see citing works
Clinical Indications to MRI in Pregnancy
Brunelli, R., & Masselli, G. (2015) · Springer eBooks · doi:10.1007/978-3-319-21428-3_1 · Cited by 3 · see citing works
- Authors
- Glantz, C., & Purnell, L.
- Affiliations
- University of Rochester Medicine (US)
- Venue
- Journal of Ultrasound in Medicine
- Publisher
- Wiley
- Published
- 2002-08
- Volume
- 21
- Issue
- 8
- Pages
- 837-840
- ISSN
- 0278-4297 (ISSN-L)
- 1550-9613
- OpenAlex
- W2129879632
- Cited by
- 246
- References
- 5
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 8 · 2023: 9 · 2022: 9 · 2021: 14 · 2020: 8 · 2019: 5 · 2018: 10 · 2017: 65 · 2016: 12 · 2015: 10 · 2014: 11 · 2013: 14 · 2012: 10
- FWCI
- 1.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Ultrasound in Medicine (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, prenatal ultrasound, sensitivity and specificity, predictive value, tocolysis, betamethasone, preterm birth, low birth weight, neonatal intensive care admission, vaginal bleeding, perinatal outcomes
- MeSH terms
- Abruptio Placentae, Female, Hematoma, Humans, Predictive Value of Tests, Pregnancy, Sensitivity and Specificity, Ultrasonography, Prenatal
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