Perinatal outcome in normotensive and hypertensive patients with placental abruption

Abstract

OBJECTIVE: To test the hypothesis that hypertensive women with placental abruption have similar perinatal outcomes when compared to those of normotensive women. STUDY DESIGN: The clinical records of women with diagnosis of abruptio placentae were identified retrospectively by a computer search of files of all parents who delivered between April 1,1996 and June 30,1997 at SSK Ankara Maternity and Women's Health Teaching Hospital. Only women of singleton pregnancies beyond 20 weeks' gestation who were delivered by cesarean section were included for data analysis (n:87). Maternal and neonatal records were reviewed and abstracted for maternal age, gestational age at delivery, antepartum complications, grade of placental abruption, birth weight, Apgar scores and perinatal mortality. The women with placental abruption were divided according to their hypertensive (n=26) and normotensive (n=61) status. The two patient groups were compared by using two-tailed independent t test for parametric data, chi square test and two-tailed Fisher's exact test for nonparametric data, where appropriate. RESULTS: The two patient groups were similar with regard to age, parity and gestational age at delivery. Hypertensive women were more likely to give stillbirths than do normotensive women (57.7% versus 27.9%, p< 0.01). Hypertensive women were delivered of neonates with birth weights lower than those of normotensive patients (1888+740 g. versus 2357+886 g., p< 0.05). The overall perinatal mortality rate for the hypertensive group was significantly higher than that of normotensive women (69.2% versus 44.2%, p<0.05). CONCLUSION: Placental abruption is a dangerous obstetric problem which is associated with a high perinatal mortality; especially in women with hypertensive disorders. (Gynecol Obstet Reprod Med 1997; 3:340-343)