SEARCH · PubMed Health

Results for “ABRUPTIO PLACENTAE”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 991 records · Page 55Linked to original sources

PubMed1988

Stillbirths in Auckland 1983-1986.

One hundred and ninety eight stillbirth deliveries occurred in three major obstetric departments of Auckland hospitals between July, 1983 and June, 1986. Post mortem examinations were performed in 74.7% of cases. The overall stillbirth rate was 5.92 per 1000 total births and the major causes of death were fetal abnormality, fetal anoxia and unexplained fetal death. Of normally formed stillbirths, about 60% occurred in uncomplicated pregnancies. Intracranial haemorrhage was common amongst Pacific Island patients while abruptio placentae occurred more commonly in caucasians. The study suggests that stillbirths occur more commonly in small for dates infants at earlier gestations, but this trend has disappeared by term. Cord problems were rare and occurred mainly in babies over 2500 g, and the absence of post mortem evidence of anoxia in the majority of these babies may suggest that the cord complications occurred as a post mortem phenomenon. Cardiotocographs were recorded 24 hours prior to death in 16 patients. The risk of stillbirth during each subsequent week of pregnancy is calculated and it is found that this risk increases sharply after 42 weeks gestation.

Birth Weight↗

PubMed1988

[Neonatal cystic leukomalacia. Perinatal case histories of 30 survivors].

In 30 surviving neonates, close prolonged ultrasonographic brain studies demonstrated cystic periventricular leucomalacias (CPVL) of varying degree (11 minor forms, 12 moderate forms, 7 severe forms). Clinical histories were reviewed for each case. There were 18 boys, 4 twins, 2 small-for-dates. Mean gestational age was 31 +/- 2 weeks, mean birthweight was 1532 +/- 356 g. No pregnancy was normal, but prenatal events were of a common occurrence in 26/30 cases (premature labor, toxaemia, twins...). Immediate perinatal events included cord difficulties in 5 cases (3 tight cords around the neck, 1 prolapse, 1 case where loose cord around the neck came down with the head), abruptio placentae (2), acute fetal distress (10, of which 8 were severe), Apgar scores 0-1 (9, of which 7 occurred after fetal distress and 2 were unexpected). In four cases, CPVL were of antenatal origin (already in the cystic stage on days 1-2). In 2 cases, CPVL occurred postnatally (infective shock on day 1 and day 46). Plausible mechanisms for anoxic-ischaemic lesions could only be found in 13 cases and remained unknown in the other 17. However, clinical histories suggested the following; cumulative minor events might become as damaging as single major events; "minor" fetal distresses should be scrutinized; pregnant women should be taught not to wait until late to arrive at hospital because this results in non-monitored delivery. No obvious relationship was found between the severity of known events and the degree of CPVL, but a number of pre- and perinatal periods were poorly monitored. The legal importance of early ultrasonographic studies was stressed.

Encephalomalacia↗

PubMed1988

Influence of perinatal care on stillbirths in patients of low socio-economic class.

In a series of 12,587 deliveries in patients of low socio-economic class, there were 356 stillbirths; prospective analysis of these showed that 42.1% occurred in the 4.7% of cases in which the mother had received no antenatal care. When booked and unbooked patients were compared it was found that the rate of stillbirths due to infection and anoxia was significantly higher among unbooked patients, who also accounted for more intra-uterine deaths due to abruptio placentae and congenital abnormalities. We speculate that diet and nutrition might play a major part in the causation of these intra-uterine deaths.

Female↗

PubMed1988

The effect of cocaine abuse on birth weight and gestational age.

A retrospective study of 343 women who lacked prenatal care was conducted to ascertain the effect of recent cocaine abuse on birth weight and gestational age. All pregnant women admitted in labor to a large urban teaching hospital between January 1 and December 31, 1986 who had not received prenatal care were included. The charts of these women were evaluated to obtain information about medical and obstetric complications of pregnancy, labor and delivery, and birth weight and gestational age of the infant. Information about drug use was obtained by urine toxicology at the time of admission. Results of ordinary least-squares multiple regression analyses indicated cocaine abuse to be a significant predictor of low birth weight and early gestational age. No correlation was found between cocaine abuse and abruptio placentae or maternal hypertension.

Adolescent↗

PubMed1987

[Pregnancy and delivery in grand multiparas in Morocco].

The authors analysed 602 case histories of patients who had had 6 deliveries or more in order to evaluate the prognosis of grand multiparity and its repercussions on the mother and infant. The authors point out that all the complications of pregnancy and the puerperium can occur but with an increased frequency. In particular toxaemia of pregnancy, abruptio placentae and dystocic labours, as well as uterine rupture, occur. The prognosis for the fetus is also made worse because they are threatened with prematurity and death. The authors conclude that only making antenatal care obligatory and a better acceptance of family planning could one day bring success to the fight against the rapid advance to grand multiparity which is not controlled and to avoid the risks of the condition.

Delivery, Obstetric↗

PubMed1987

Addiction in pregnancy: high risk intrapartum management and outcome.

Drug-dependent women (DDW) have an increased incidence of medical and obstetrical complications; however, little information exists on the intrapartum course and management of these patients. Within the context of Family Center, a study was undertaken to determine if the DDW had normal patterns of labor and if standard intrapartum management is appropriate. The study population included 336 women of which 112 were DDW (72 per cent receiving methadone maintenance). The comparison group of 224 non drug dependent women was matched for gravidity, parity, and socioeconomic background. The incidence of premature delivery, abruptio placentae, breech presentation, and intrauterine growth retardation were significantly greater in the DDW. The average duration of the first, second, and third stages of labor compared well with the normal course of labor and matched the results of the comparison group. Labor abnormalities and cesarean sections were of no greater incidence, but there were more than twice as many forceps deliveries which coincides with the 40 per cent increased use of epidural anesthesia. Analgesia and anesthesia were in excess of that which is given to the average patient. There were three stillborns, one neonatal death, and one maternal death. Apgar scores and the incidence of fetal distress and meconium staining were identical in both groups. Postpartum complications were more common in the DDW, but most were secondary to the use of subclavian intravenous lines inserted due to the presence of sclerotic veins. These data suggest that high risk prenatal management and careful monitoring in the intra- and postpartum periods utilizing epidural anesthesia identifies and usually prevents untoward complications in DDW.

Adult↗

PubMed1987

Fetal and neonatal outcome in patients with severe pre-eclampsia before 34 weeks.

Delivery was delayed until 34 weeks in 129 patients with severe pre-eclampsia, unless the maternal or fetal conditions necessitated earlier delivery. No patient developed eclampsia although all sedation was terminated from 24 hours after admission until labour started, unless there was a sudden change in the patient's clinical condition. Of the 14 fetuses that died in utero, only 4 weighed more than 1,000 g at delivery. Three of these 4 had already died by the time of the mothers' admission. Abruptio placentae was the cause of 36% of intra-uterine deaths. The perinatal mortality rate was 223/1,000. Survival rates for liveborn babies were 47%, 78% and 82% for birth weights of 750-999 g, 1,000-1,249 g and 1,250-1,499 g respectively. No neonate died when the birth weight was 1,500 g or more.

Adult↗

PubMed1987

Persistent pulmonary hypertension: assessment of perinatal risk factors.

Persistent pulmonary hypertension of the neonate, a disease of unknown etiology, is associated with a mortality rate as high as 50%. We conducted a retrospective study (1979-1983) to identify antenatal events that may be associated with this disease. Thirty-seven mothers of neonates with this disorder were compared with 150 randomly selected control patients. Logistic regression analysis revealed that meconium, maternal fever (caused by urinary tract infection, upper respiratory infection, chorioamnionitis, and unknown causes), maternal anemia (caused by abruptio placentae, placenta previa, and unknown causes), and maternal pulmonary disease (caused by asthma and/or pneumonia) were associated with persistent pulmonary hypertension of the neonate. The computed odds ratios for the variables associated with this disease were increased significantly above the controls. In addition, cesarean section, nonvertex presentation, fetal distress, and vaginal bleeding were found to be significant on univariate analyses. The cesarean section rate in the study group was 59%, with the primary indications of fetal distress and/or third-trimester bleeding in 77.3% of instances. These data suggest that antenatal risk factors and the computed odds ratio may help identify pregnancies likely to produce infants at high risk for persistent pulmonary hypertension of the neonate.

Asphyxia Neonatorum↗

PubMed1986

Maternal mortality in Cape Town, 1978-1983.

During 1978-1983, 57 maternal deaths (23 in blacks, 32 in coloureds and 2 in whites) occurred among 131,288 deliveries (36,564 in blacks, 89,335 in coloureds and 5389 in whites) in the Peninsula Maternal and Neonatal Service, Cape Town. Data for whites were not analysed further. Maternal mortality rates (MMRs) were higher in blacks than in coloureds. Age- and parity-specific MMRs showed that black teenagers and primiparas and coloureds aged 20-34 years and of parity 2-4 had the lowest rates. Advanced age and grand multiparity had a much greater adverse effect in coloureds than in blacks. Eighteen per cent of deaths in blacks and 9% of those in coloureds were in unbooked patients. The main causes of death (obstetric and non-obstetric) in blacks were sepsis, abruptio placentae, eclampsia and pneumonia. In coloureds they were eclampsia, other manifestations of proteinuric hypertension, cardiac disease, sepsis, haemorrhage (grouped) and diabetes. Of those who died, 43% of blacks and 38% of coloureds had had a caesarean section. The perinatal mortality rate was 417 for blacks and 469 for coloureds. A number of avoidable factors were identified. Most, if not all, deaths occurred because simple perinatal rules were broken.

Adult↗

PubMed1987

Spontaneous prolonged contractions during antenatal fetal heart rate monitoring.

Uterine contractions of more than 2 minutes' duration occurred spontaneously in 1.4% of 6,399 antenatal fetal heart rate (FHR) recordings. All recordings were made in the Department of Obstetrics and Gynaecology at Tygerberg Hospital. The patients with spontaneous prolonged contractions (SPC) were compared with a randomly selected control group. Patients who had an SPC during antenatal FHR recording were not at a higher risk of abruptio placentae, preterm labour or unexpected intra-uterine death. Of the infants born to the mothers in the study group, 65.5% were male. There were more primigravidas in the study group, which may have been responsible for the longer duration of the second stage of labour in this group. When primigravidas only were examined no difference between the two groups could be found except for a larger placental mass in the study group. It is uncertain why primigravidas were more likely to develop SPCs as observed during antenatal FHR monitoring.

Delivery, Obstetric↗

PubMedDate not supplied

[Perinatal medical possibilities and limitations of the obstetrical center--an analysis of the causes of perinatal mortality 1982-1985].

Based on the analysis of 4,881 deliveries during 1982-1985 the perinatal statistical data of a regional perinatal center (level 3) are presented. There is high percentage of pregnancies at risk (57%), preterm deliveries (11%), and increasing incidence of multiple pregnancies (3%). The rate of spontaneous deliveries amounts to more than 70%, the frequency of cesarean sections reached a maximum of 19%. As causes of 82 perinatal deaths (16.8% mortality rate) were found above all fetal malformations (42%), multiple pregnancy (18%), severe intrauterine growth retardation (17%), and premature rupture of membranes with septic complications (10%). Further causes of perinatal death were severe umbilical cord complications (5%), diabetic pregnancy (5%), abruptio placentae and maternal high risks. After detailed analysis 55% of all perinatal deaths proved to be unavoidable, 18% possibly avoidable, and 27% avoidable. The presentation of the avoidable perinatal deaths demonstrates the shortcomings and possible improvements of the obstetrical management and organization. The possibly avoidable cases could be solved in future. According to the purged perinatal mortality rate there are 4 remaining avoidable cases for which the perinatal center proved to be responsible. The perinatal mortality risk in the regional center is therefore less than 1%o.

Congenital Abnormalities↗

PubMed1985

Effect of anaemia and other maternal characteristics on birthweight.

A cross-sectional study was done on 982 mothers who delivered in four different government hospitals in Metro Manila and whose pregnancy was unassociated with pre-eclampsia, diabetes mellitus, chronic hypertension, cardiovascular disease, abruptio placenta, placenta praevia and multiple pregnancy. The relationship of birthweight and anaemia and other maternal characteristics was examined by multiple regression analysis. Birthweights did not correlate with maternal haemoglobin levels. However, anaemic mothers showed placental hypertrophy. The hypertrophy is probably a compensatory physiological response to ensure adequate oxygen supply to the fetus. Birthweight increased with gestational age affirming the fact that low birthweight is partly due to shortened gestational age. Haemoglobin level significantly increased with maternal age but decreased with increasing parity.

Adult↗

PubMed1986

Effect of mode of delivery on morbidity and mortality of infants at early gestational age.

The effect of mode of delivery on the mortality and morbidity of 26- to 32-week neonates was studied. Five hundred six consecutive deliveries at 26 to 32 weeks' gestation were reviewed. The populations were divided into high-risk and low-risk neonates by evaluation of antepartum variables known to increase neonatal risk, ie, abruptio placenta. One hundred ninety-six infants were classified as low risk. In this group, 124 vaginal and 72 cesarean section deliveries were compared using demographic, peripartum, and neonatal variables. Cesarean delivery was associated with highly significant maternal morbidity, including a 30% incidence of vertical uterine incision. No difference in neonatal mortality was shown. Cesarean delivery was associated with lower one-minute Apgar scores and a greater incidence and severity of hyaline membrane disease. No neonatal differences were shown in the incidence of trauma, intraventricular hemorrhage, or seizures. This study does not support cesarean delivery of all tiny neonates.

Apgar Score↗

PubMedDate not supplied

[Problem of fetal arrhythmias--a case report].

A fetal congenital complete AV-block was detected in the 30th week of gestation. After close sonographic and cardiotocographic follow-up examinations premature labor occurred in the 37th week of gestation. The interpretation of the fetal heart rate pattern was difficult. The bradycardia was accompanied by late decelerations (dip II), only different from familiar hypoxia-patterns by the bradycardia. Caesarean section therefore was immediately done. A partial abruptio placentae was found as causing hypoxia. The child developed well after insertion of a temporary transvenous pacemaker. The AV-block is still persisting. At the age of three months the child fell ill of an acute cutaneous lupus erythematosus. The symptoms disappeared after unspecific treatment. Antinuclear antibodies pathognomonic for lupus erythematosus were traceable in the symptomless mother. There are other observations of motherly autoantibodies passing the placental barrier impairing the fetal heart conduction.

Adult↗

PubMed1985

Maternal and perinatal outcome of conservative management of severe preeclampsia in midtrimester.

Pregnancies complicated by severe preeclampsia in the second trimester are associated with a high incidence of perinatal morbidity and mortality. One way to possibly improve perinatal outcome in these pregnancies is to attempt to prolong the gestation with conservative management. Reported here the results of conservative management of 60 consecutive patients with severe preeclampsia in the second trimester (18 to 27 weeks' gestation). Although there were no maternal mortalities, the morbidity rate for the 60 patients was very high. Severe maternal complications included abruptio placentae (n = 13), eclampsia (n = 10), coagulopathy (n = 5), renal failure (n = 3), hypertensive encephalopathy (n = 2), intracerebral hemorrhage (n = 1), and ruptured hepatic hematoma (n = 1). In addition, perinatal outcome for these pregnancies was exceptionally poor, with 31 of the 60 pregnancies resulting in a stillborn infant, and 21 resulting in a neonatal death, for a total perinatal mortality rate of 87%. Thus, the results of this retrospective study do not support the use of conservative management for pregnancies complicated by severe preeclampsia in the second trimester.

Administration, Oral↗

PubMed1979

Neonatal apnea: underlying disorders.

Data from a prospective study of 50,826 neonates were used to determine the frequency and significance of disorders related to apnea in newborns. Such apnea proved to be a significant prognosticator for neonatal death. Fifty-eight percent of preterm neonates with multiple apneic episodes and 18% with a single episode died, whereas only 6% of those without recorded apnea died. The rates were 44%, 5%, and 1% for full-term infants. Amniotic fluid infection was the underlying disorder in 35% of the preterm and 25% of the term neonates who had multiple episodes of apnea. A third of the preterm and 25% of the term infants who had such apneic episodes had antecedent hypoxia-related disorders, i.e., abruptio placentae, erythromblastosis fetalis, placenta previa, large placental infarcts, and umbilical cord compression. Among the apneic neonates, those who were infected were twice as apt to die as were those who had hypoxia-related disorders. Hypoplasia of the lungs and easily recognized central nervous system malformations were responsible for most of the apnea-related deaths associated with congenital malformations.

Amniotic Fluid↗

PubMed1979

Trends in perinatal mortality in Cape Town, 1967--1977.

Perinatal deaths and perinatal mortality rates in Cape Town for the period 1967--1977 have been analysed, and large differences were found between the various ethnic groups. In non-Whites stillbirths accounted for more than two-thirds of perinatal deaths in 1977, and in at least 75% of these fetal death preceded labour. Perinatal mortality rates must be considered together with the number of perinatal deaths if the true magnitude of the problem with regard to the various obstetric complications and procedures is to be appreciated. The main perinatal problems as they affect the infant were (i) during pregnancy--antepartum haemorrhage (especially abruptio placentae), intra-uterine growth retardaton, multiple pregnancy, proteinuric hypertension and unbooked status; (ii) during labour and delivery--preterm labour, stillbirths (especially before labour) and vaginal breech delivery; (iii) in the early neonatnal period--immaturity and respiratory distress and neonatal infection.

Black or African American↗

PubMed1978

Fetal demise following negative contraction stress tests.

The contraction stress test (CST) has become widely used to assess antepartum fetal well-being over the past 5 years. A summary of 14 reports in the literature revealed seven fetal deaths in 1739 patients within 1 week of a negative CST, an incidence of 0.4%. This prompted an investigation of our results for comparison. During the period January 1, 1975, to February 28, 1977, 746 patients underwent 1119 CSTs. Seven fetal deaths occurred in 680 patients within 1 week of a negative CST, an incidence of 1.0%. Although maternal conditions associated with fetal demise within 1 week of a negative CST include diabetes mellitus, prolonged pregnancy, chronic hypertension, and pre-eclampsia, fetal death in most instances resulted from factors other than uteroplacental insufficiency (UPI). Conditions commonly associated with fetal demise following a negative CST were umbilical cord accidents, severe congenital anomalies, and abruptio placentae. The low incidence of fetal death after a negative CST supports continued use of the CST in evaluation of high-risk pregnancies.

False Negative Reactions↗