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PubMed1995

Retinal detachment in association with preeclampsia and abruptio placentae.

Retinal detachment is a rare complication of preeclampsia, eclampsia and abruptio placentae. We report a case of bilateral retinal detachment in association with severe preeclampsia complicated with abruptio placentae, intrauterine fetal death and disseminated intravascular coagulation. In obstetric complications, placental thromboplastin may release into maternal circulation and activate the extrinsic coagulation system with resultant disseminated intravascular coagulation. This may be responsible for choroidal ischemia and consequent serous retinal detachment.

Abruptio Placentae↗
PubMed1994

Fetal and uteroplacental flow velocity waveforms in abruptio placentae: report of two cases.

This paper reports two cases of abruptio placentae assessed using pulsed Doppler at 29 and 30 weeks of gestation. Transvaginal pulsed Doppler showed abnormal uterine artery FVWs in both cases. One fetus with normal umbilical and normal middle cerebral artery FVWs was not acidotic and only midly hypoxic, whereas the other fetus with normal umbilical and abnormal middle cerebral artery FVWs was severely acidotic and hypoxic at birth. It is suggested that Doppler assessment of fetal blood distribution is of great value for the rapid diagnosis of fetal asphyxia, and that uteroplacental FVWs provide reliable information on which to base the diagnosis of abruptio placentae.

Abruptio Placentae↗
PubMed1994

Ultrasound in abruptio placentae praecox of the second twin. 'Boomerang phenomenon'.

The diagnosis of abruptio placentae praecox of the second twin is usually difficult. The clinical symptoms may not be evident. The appearance of the new (third) hypoechogenic space, on ultrasound scan, was in our case the only diagnostic clue. It proved to be blood from the abrupted edge of twin B's placenta penetrating the dividing septum. Its characteristic ultrasound image brought forward the idea and namegiving 'boomerang phenomenon' and indeed, it could return like a boomerang as the intrauterine fetal demise, if ignored. This picture could mislead to the conclusion of being the leakage of amniotic fluid or the amniotic sack of the 'vanishing fetus' in primarily triplet pregnancy. The potentially ominous prognosis of abruptio placentae praecox warrants strict supervision of pregnancies with this phenomenon.

Abruptio Placentae↗
PubMedDate not supplied

Sinusoidal pattern of uterine contractions in abruptio placentae.

Three cases of vaginal bleeding during labor associated with high-frequency uterine contractions (HFUC) in the third trimester of pregnancy are reported. Abruptio placentae was confirmed in all three cases. As HFUC was unrecognized as a sign of abruptio placentae, labor was allowed to continue in the first two cases and fetal demise ensued. The appearance of HFUC with vaginal bleeding in the third trimester of pregnancy should make the obstetrician highly suspicious of abruptio placentae. Labor should be terminated by cesarean section to prevent fetal death in utero.

Abruptio Placentae↗
PubMed1986

Comparison of blood levels of vitamin A, beta-carotene and vitamin E in abruptio placentae with normal pregnancy.

Levels of vitamin A, beta-carotene and vitamin E in peripheral venous blood of women in abruptio placentae and in normal pregnancy have been compared. Chemical methods were used for the estimation of these compounds. The results show that levels of all three compounds in abruptio placentae are lower than those found in the normal pregnancy. We have earlier shown that levels of ascorbic acid in these subjects are low while other studies have indicated that levels of folic acid in them are also low. Based on our present and earlier published work it is suggested that abruptio placentae is a condition with multiple vitamin deficiency. Whether this is its cause or effect is however not clear.

Abruptio Placentae↗
PubMed2002

Postpartum hemolytic uremic syndrome following abruptio placenta: report of a case.

Postpartum hemolytic uremic syndrome (HUS) is an unusual complication that presents with microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure after delivery. In this report, we describe a 32-year-old patient (gravida 3, para 1, artificial abortion 1) who developed postpartum HUS following abruptio placenta. After cesarean delivery due to abruptio placenta, the patient developed acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia followed by hypertension. Plasma exchange led to recovery from thrombocytopenia and improvement in renal function. This case highlights the importance of observation of peripheral blood smears in patients with abruptio placenta who develop thrombocytopenia after delivery.

Abruptio Placentae↗
PubMed1992

[Analysis of 65 cases of abruptio placenta].

From Jan 1, 1971 to Dec 12, 1990, 65 cases of abruptio placenta were admitted to our hospital. The incidence was 0.19%. Among them, thirty were complicated by pregnancy induced hypertension (46.2%). The perinatal fetal mortality was 19.7%; perinatal death occurred mostly in the premature group. All babies survived except two abnormalities. Cesarean section rate was 32.3%. All postpartum hemorrhage 29.2%. Couvelaire uterus 6.2%, were cured by conservative treatment. There was neither stillbirth nor newborn death in the thirty three cases treated expectant, but a newborn asphyxia rate of 6.1% and a cesarean section rate of 15.1%. Analysis showed that abruptio placentae should be suspected in cases with abnormal fetal heart rate of unknown cause accompanying signs of labor, premature labor of unknown cause, uterine tongue, ultrasonically visualized liquid from dark area behind the placenta, besides classical signs of abdominal pain and vaginal bleeding. Expectant treatment is appropriate if gestational age is small and no acute symptoms exists so as to minimize the perinatal mortality and cesarean section rate.

Abruptio Placentae↗
PubMed1992

Plasma fibronectin receptor levels during pregnancy complicated by preeclampsia and abruptio placentae.

The level of human fibronectin receptor (FNR) in plasma was measured by enzyme-linked immunosorbent assay in samples from normal pregnant women in the 1st trimester (n = 5), 2nd trimester (n = 7), 3rd trimester (n = 23), normal postpartum women day 1 (n = 4), day 2 (n = 5), day 3 (n = 8), nonpregnant women (n = 18), 20 preeclamptic patients in the 3rd trimester, and 8 patients with abruptio placentae in the 3rd trimester. In normal pregnancy, the mean value of FNR was 1.4 +/- 0.4 micrograms/ml in the 1st, 1.4 +/- 0.2 micrograms/ml in the 2nd, and 1.9 +/- 0.3 micrograms/ml (p less than 0.05) in the 3rd trimester. FNR values increased with pregnancy. During the puerperium, its level decreased with time, being 1.4 +/- 0.5 micrograms/ml (p less than 0.01) on day 1, 1.0 +/- 0.3 micrograms/ml on day 2, and 0.8 +/- 0.2 micrograms/ml on day 3. The level in preeclamptic patients was 2.0 +/- 0.4 micrograms/ml, and that in abruptio placentae was 2.7 +/- 0.4 micrograms/ml. There were significant differences between the levels in abruptio placentae versus preeclampsia (p less than 0.05) and 3rd-trimester normal pregnant women (p less than 0.01). In the immunohistochemical study, the surface of normal decidual cells stained weakly for FNR, and the decidual cell membranes of the cases of preeclampsia stained moderately or strongly. Decidual cells and their extracellular matrix close to hematomas of abruptio placentae stained very strongly for FNR.(ABSTRACT TRUNCATED AT 250 WORDS)

Abruptio Placentae↗
PubMedDate not supplied

[Uterine pathomorphology in abruptio placentae].

15 uteri removed surgically because of abruptio placentae (AP) were studied morphologically. AP develops as a process due to a combination of maternal (endometritis, gestosis, adenomyosis), placental (pathology of microvilli, hypercoagulation of venous blood) and hemorheological (thrombosis of placental bed veins, partial blockade of venous circulation) factors. These factors result in the formation of retroplacental hematoma and progressing intrauterine fetal hypoxia.

Abruptio Placentae↗
PubMed1998

Resistance to activated protein C and the leiden mutation: high prevalence in patients with abruptio placentae.

OBJECTIVE: The Leiden mutation, a point mutation in the gene encoding coagulation factor V, is associated with a high frequency of thromboembolic phenomena. It has recently been connected with adverse outcomes of pregnancy. We carried out this study to define its connection with abruptio placentae. STUDY DESIGN: Twenty-seven women who had abruptio placentae and 29 control subjects matched for age, parity, and ethnic origin were studied. We studied all women for possible hypercoagulation defects. All women demonstrating resistance to activated protein C were studied for the presence of the factor V Leiden mutation. RESULTS: Seventeen of 27 case patients had an activated protein C ratio </=2.5, compared with 5 of 29 control subjects (odds ratio 8.16, 95% confidence interval 3.6-12.75, P =.00125). Participants with activated protein C ratios </=2.5 underwent deoxyribonucleic acid analysis. Eight case patients were found to have the factor V Leiden mutation (5 heterozygous and 3 homozygous, 29.6%), compared with 1 heterozygote among the control subjects who were tested (3.4%). CONCLUSION: Factor V Leiden mutation was found quite frequently in patients with abruptio placentae.

Abruptio Placentae↗
PubMed1987

Abruptio placentae: clinical management in nonacute cases.

One hundred thirty cases of clinically diagnosed abruptio placentae encompassing the wide range of acuity were grouped by gestational age at delivery into previable, preterm, and term divisions for comparison of demographic data, presenting symptoms, delay to delivery, mode of delivery, and delivery indications. Attention was focused on the preterm group of patients to assess the implications of presenting symptoms, the usefulness of ultrasonography, and the safety and efficacy of tocolysis. Cigarette smoking and a previous poor obstetric history were found to be more frequent in the preterm compared to the term abruptio placentae. Ultrasonic visualization of a clot was successful in 25% of the preterm patients but otherwise appeared to have little or no impact on course or management. Tocolysis for the preterm patients appeared to be beneficial in prolonging gestation and did not increase the likelihood of cesarean delivery, hemorrhage, or fetal distress. The cumulative rates of delivery following admission were compared with and without tocolysis, with and without sonographic visualization of a clot, and overall as a function of gestational age at initial hospitalization. Perinatal mortality was 17%. Inpatient management with frequent fetal heart rate monitoring, tocolysis if indicated, and timely use of cesarean delivery are advocated to promote prolongation of the pregnancy and minimized perinatal mortality.

Abruptio Placentae↗
PubMed1984

Relationship of hypertensive disease to abruptio placentae.

The purpose of the present retrospective study was to examine the relationship between hypertension and abruptio placentae. Two hundred sixty-five consecutive cases of abruption were reviewed, with an emphasis on the occurrence and severity of hypertensive disease. The results confirm a close relationship between abruptio placentae and hypertension. The incidence of abruption was highest with eclampsia (23.6%), followed by chronic hypertension (10.0%) and preeclampsia (2.3%). In addition, those with eclampsia and chronic hypertension had a significantly higher perinatal mortality than those without these conditions. These data demonstrate that hypertension is associated with an increased risk of abruption. Furthermore, the degree of this increased risk is clearly dependent upon the specific type of hypertensive disorder.

Abruptio Placentae↗
PubMedDate not supplied

[Relationship between hypertensive states and perinatal prognosis in abruptio placentae].

Ninety-one occurrences of abruptio placentae were analyzed by the Department of Obstetrics of the São Paulo School of Medicine in São Paulo, Brazil during a ten-year period, from 1979 to 1988. The purpose was to analyze perinatal prognosis and its relation to hypertensive states. The authors observed that arterial hypertension was present in 75% of the cases, most of which chronic arterial hypertension; they also observed that perinatal mortality increased in the presence of high arterial blood pressure.

Female↗
PubMed1987

Risk factors for abruptio placentae.

In a prospective study 90 patients who had confirmed abruption of the placenta were compared with a control group. Significantly more patients who had abruptio placentae were unmarried, smoked cigarettes, received no antenatal care, had coitus within the 48 hours preceding delivery, developed intrapartum hypertension and had a lower ponderal index than the controls. More patients with abruptio placentae had proteinuria and antepartum hypertension but statistical significance was not reached. In addition, the incidence of intra-uterine growth retardation was higher in these patients.

Abruptio Placentae↗