Dergiler / GORM:Gynecology Obstetrics & Reproductive Medicine / 1997 / Cilt: 3 - Sayı: 3
Ablasyo plasentada maternal mortalite ve morbidite: 87 vakanın analizi
- Sayfa
- 418–422
- DOI
- —
Özet
OBJECTIVE: To determine the rates of maternal morbidity and mortality associated with placental abruption at a teaching hospital. STUDY DESIGN: The clinical records of women with diagnosis "of abruptio placentae were identified retrospectively by a computer search of files of all patients who delivered between ApriM, 1996 and June 30,1997 at our hospital. Only women of singleton pregnancies beyond 20 weeks' gestation who were delivered by cesarean section were included for data analysis (n:87). Maternal records were reviewed and abstracted for maternal mortality, maternal morbidity(morbidity defined as the development of one of the mentioned maternal complications in literature or the need of transfusion of either whole blood or blood products, febrile morbidity, postpartum hospitalization more than 5 days). RESULTS: No maternal mortality was observed in 87 pregnant women diagnosed to have placental abruption (n:0,0%). However 51 cases (58.6%) had maternal morbidity of varying degrees. Couvelaire uterus was observed in 23 cases (26.4%). Fifty patients needed whole blood transfusion (57.5%) whereas 14 cases (16.1%) needed to have fibrinogen replacement. There was a need of platelet pack transfusion in 9 cases (10.3%). Consumptive coagulopathy occured in 17 patients (19.5%) while 12 patients (13.8%) had febrile morbidity. Hemolysis, elevated liver enzymes and low counted platelets (HELLP syndrome) took place in 2 cases in the postpartum period (2.3%). Two patients had acute renal failure (2.3%).Uterine atony was diagnosed in one patient (1.1%) during cesarean section and bilateral hypogastric artery ligation was performed in this case. CONCLUSION: Abruptio placentae is still a frightening clinical entity for obstetricians with considerable maternal mortality and morbidity. (Gynecol Obstet Reprod Med 1997; 3:418-422)
Abstract
OBJECTIVE: To determine the rates of maternal morbidity and mortality associated with placental abruption at a teaching hospital. STUDY DESIGN: The clinical records of women with diagnosis "of abruptio placentae were identified retrospectively by a computer search of files of all patients who delivered between ApriM, 1996 and June 30,1997 at our hospital. Only women of singleton pregnancies beyond 20 weeks' gestation who were delivered by cesarean section were included for data analysis (n:87). Maternal records were reviewed and abstracted for maternal mortality, maternal morbidity(morbidity defined as the development of one of the mentioned maternal complications in literature or the need of transfusion of either whole blood or blood products, febrile morbidity, postpartum hospitalization more than 5 days). RESULTS: No maternal mortality was observed in 87 pregnant women diagnosed to have placental abruption (n:0,0%). However 51 cases (58.6%) had maternal morbidity of varying degrees. Couvelaire uterus was observed in 23 cases (26.4%). Fifty patients needed whole blood transfusion (57.5%) whereas 14 cases (16.1%) needed to have fibrinogen replacement. There was a need of platelet pack transfusion in 9 cases (10.3%). Consumptive coagulopathy occured in 17 patients (19.5%) while 12 patients (13.8%) had febrile morbidity. Hemolysis, elevated liver enzymes and low counted platelets (HELLP syndrome) took place in 2 cases in the postpartum period (2.3%). Two patients had acute renal failure (2.3%).Uterine atony was diagnosed in one patient (1.1%) during cesarean section and bilateral hypogastric artery ligation was performed in this case. CONCLUSION: Abruptio placentae is still a frightening clinical entity for obstetricians with considerable maternal mortality and morbidity. (Gynecol Obstet Reprod Med 1997; 3:418-422)