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At least 19 recordsLinked to original sources
PubMed1997

Assessing the relationship between maternal cocaine use and abruptio placentae.

Abruptio placentae during pregnancy can result in significant morbidity and mortality to both mother and infant. A comprehensive literature search of publications from 1966 to April 1995 identified 11 studies on the association between maternal cocaine use and abruptio placentae. Their results were combined in a meta-analysis. The pooled odds ratio for abruptio placentae and maternal cocaine use was 3.92 (95% confidence interval 2.77-5.46). The strength and consistency of the association, its biological plausibility and the results of experimental studies in animals all suggest that cocaine use during pregnancy causes abruptio placentae.

Abruptio Placentae↗
PubMed1957

Modern treatment of abruptio placentae.

Abruptio placentae, in its severe form, causes the most hazardous type of third trimester bleeding. The severe grade may be accompanied by systemic effects, some of which are potentially lethal. A knowledge of these, as well as a system of grading the severity in terms of maternal risk, is essential to an understanding of therapy. Cases should be graded in severity from I to III on the basis of clinical factors. A delay in delivery, in Grade III, may result in an increased incidence of serious maternal complications. In Grade II, immediate cesarean section has reduced the fetal mortality rate. IN MANAGING GRADE III PREMATURE SEPARATION OF THE PLACENTA, THE FOLLOWING STEPS SHOULD BE CARRIED OUT: (1) Laboratory study, including blood cross-matching and determination of plasma fibrinogen; (2) vaginal examination to confirm the diagnosis and to rupture of the membranes; (3) indicated therapy of systemic effects with fresh whole blood and fibrinogen, before considering any operative delivery; (4) election of a mode of delivery which will terminate the pregnancy in less than about six hours after onset of separation; this will frequently be cesarean section; (5) careful attention to postpartum care to avoid shock and renal failure. In Grade II, the same principles of therapy obtain. If the fetal heart tones are present, however, and vaginal delivery is not imminent, immediate cesarean section is justified. Complete conservatism, with vaginal delivery, is recommended in Grade I.

Abruptio Placentae↗
PubMed1983

Rh immunoglobulin use with placenta previa and abruptio placentae.

Patients with obstetric hemorrhage from placenta previa or abruptio placentae may be at increased risk of Rh sensitization because they fail to receive Rh immunoglobulin (RhIG) or are given an inadequate dose. To evaluate the use of RhIG in this clinical situation, we studied 498 patients with hemorrhage from placenta previa or abruptio placentae treated at a large municipal hospital from 1975 to 1979. All 25 RhIG candidates received the product before their discharge from the hospital. This rate of RhIG use was equal to that for patients whose infants were delivered without these complications and significantly higher than that for patients with spontaneous abortion and ectopic pregnancy at the same hospital (P less than .05). Prompt administration of an adequate dose of RhIG to candidates with bleeding from placenta previa or abruptio placentae can further reduce Rh hemolytic disease.

Abortion, Spontaneous↗
PubMed1996

The association of cigarette smoking with placenta previa and abruptio placentae.

Smoking was recognized as having an adverse effect of pregnancy outcome as early as the mid 1950s. Smoking is a well recognized risk factor for low birthweight infants and has been implicated in preterm birth. The increased risk of both placenta previa and abruptio placentae among women who continue to smoke during pregnancy, is in general, less well recognized, but supported by numerous studies. The purpose of this article is to review the published literature dealing with the risk of placenta previa and abruptio placentae in women who smoke during their pregnancy.

Abruptio Placentae↗
PubMed1991

CA 125 levels in abruptio placentae.

The diagnosis of abruptio placentae is frequently difficult despite ultrasonography; additional diagnostic parameters would be useful. Maternal serum CA 125, which is believed to derive from the decidua, is elevated in the first trimester and immediately after delivery when placental separation occurs, possibly because of decidual disruption. Serum CA 125 was measured in 27 patients beyond 20 weeks' gestation who were first seen with vaginal bleeding and in 17 control patients of similar gestational age and labor status. Mean (+/- SD) CA 125 levels were higher (p less than 0.01) among patients with abruptio placentae (105.9 +/- 115 U/ml) than among those with alternate sources of bleeding (13.7 +/- 10 U/ml) or control patients (18.2 +/- 11.7 U/ml). Mean (+/- SD) serum CA 125 levels in seven control patients within 6 hours post partum (194 +/- 80.5 U/ml) were higher than those among patients first seen with abruptio placentae (p less than 0.01). Sensitivity and specificity of CA 125 for abruptio placentae were 70% and 94%, respectively. Our data support a decidual source for CA 125 and may indicate utility of CA 125 as a marker for abruptio placentae.

Abruptio Placentae↗
PubMed1993

[The study on mechanism of abruptio placentae caused by chorioamnionitis].

The cause of abruptio placentae has not been elucidated yet. Although preeclampsia is frequently associated with abruptio placentae, the rate of abruptio placentae caused by preeclampsia has decreased recently. Many current reports have indicated that chorioamnionitis is an important cause of abruptio placentae. To clarify the relationship between chorioamnionitis and abruptio placentae, we performed immunostaining for fibronectin, fibronectin receptor and granulocyte elastase of placenta with or without abruptio placentae. In cases of abruptio placentae caused by chorioamnionitis, granulocyte elastase was stained strongly and fibronectin receptor was stained weakly in decidual cells, especially in the parts of granulocyte elastase invased. In III stage chorioamnionitis without abruptio placentae, granulocyte elastase was stained moderately and the intensity of fibronectin receptor did not decrease. There was no difference between fibronectin staining in all cases. When purified granulocyte elastase was added to the cultured decidual cells, the staining intensity of fibronectin receptor became weak in those cells. These results suggest that marked imbalance between neutrophil invasion and an inhibitor, such as alpha 1 antitrypsin, initiates granulocyte elastase release and promotes the reduction of the fibronectin receptor in decidual cells resulting in weakening of the adherence of decidual cells. This may be one of the mechanisms of abruptio placentae caused by chorioamnionitis.

Abruptio Placentae↗
PubMed1988

Frequent fetal heart-rate monitoring for early detection of abruptio placentae in severe proteinuric hypertension.

Abruptio placentae occurred in 16 of 132 patients with severe pre-eclampsia who were admitted to an obstetric high-risk ward before 34 weeks' gestation. These 16 patients were compared with those who did not develop abruptio placentae. Systolic and diastolic blood pressure levels, proteinuria and birth weights did not differ significantly between the two groups. Apgar scores were significantly lower in the abruptio placentae group. There were 6 intra-uterine and 2 neonatal deaths in the abruptio placentae group (50% perinatal mortality (PNM] and 3 intra-uterine and 16 neonatal deaths in the other group (18% PNM). Four patients with abruptio placentae presented with abnormal fetal heart-rate patterns and 8 with abdominal pain. No warning signs were present in 3 patients and the fetal heart-rate pattern before delivery was not available in 1 patient. Abnormal fetal heart-rate patterns were present in 5 of the 8 patients who presented with pain. Abruptio placentae occurring in patients with severe proteinuric hypertension carries a high PNM. Frequent monitoring of the fetal heart rate sometimes helps to diagnose fetal distress before the clinical signs of abruption become apparent.

Abruptio Placentae↗
PubMed1982

[Alterations in coagulation and fibrinolytic system in abruptio placentae (author's transl)].

Abruptio placentae tends to be accompanied by abnormal coagulation and fibrinolysis, and is known as high risk pregnancy allowing both mother and fetal lives to endanger. Blood coagulation and fibrinolytic system in abruptio placentae, in particular, sequential changes around its onset have been remained unclarified despite the progress in hematology. This permits an irregular therapeutical process for its acute clinical manifestation. In this study, observation was made of the changes of coagulation and fibrinolytic system mainly in relation to delivery, and hemorrhagic diathesis in abruptio placentae was studied. The results obtained are as follows. The studied patients were 14 cases classified into 8 multipara, 10 toxemia of pregnancy, 6 cesarean section, 11 intrauterine fetal death, and 8 complicated disseminated intravascular coagulation respectively. A moderate type demonstrating an increased serum FDP with retarded ESR and lowering in fibrinogen level were observed, but those abnormalities recovered to normal by 3 days after delivery. In serious case, observations also were made of marked decrease of fibrinogen, prolonged PT and PTT, high concentrations of serum and urinary FDP, lowering in levels of coagulation factors, attenuated platelet counts, retarded ESR, and inhibition of platelet aggregation along with thrombelastgram that showed thrombocytopenic type. All of those anomalies tended to be improved following delivery.

Abruptio Placentae↗
PubMed2004

Severe vasovagal attack: an unusual cause of abruptio placentae.

CASE REPORT: Abruptio placentae occurred in a 29 years old woman following a vasovagal episode. Her medical history was free from all the commonly accepted risk factors for abruption. DISCUSSION: We speculate that the restoration of placental blood flow caused a sudden increase in uteroplacental blood pressure, and induces rupture of some vessels, causing a progressively growing retroplacental hematoma and placental detachment.

Abruptio Placentae↗
PubMed1974

Heparin treatment in abruptio placentae.

Two cases of abruptio placentae with disseminated intravascular coagulation (DIC) were treated with heparin, and coagulation was monitored by thromboelastography as well as the usual hematology tests. The cases demonstrated the vagaries of DIC and both showed decreased overt hemorrhage after heparin treatment was started. Heparin may be indicated for the management of abruptio placentae where delivery is not imminent, where significant disseminated intravascular coagulation exists, and when adequate serial coagulation studies are available.

Abruptio Placentae↗