Gueneuc A, Carles G, Lemonnier M, Dallah F, Jolivet A, Dreyfus M
Service de gynécologie obstétrique et médecine de la reproduction, FEH, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France.
Service de gynécologie obstétrique, centre hospitalier de l'Ouest Guyanais, 16, boulevard du Général-Leclerc, BP 245, 97393 Saint-Laurent du Maroni, Guyane française.
J Gynecol Obstet Biol Reprod (Paris). 2016 Mar;45(3):300-6. doi: 10.1016/j.jgyn.2015.04.003. Epub 2015 Apr 29.
To describe the epidemiological, clinical and prognostic factors of placental abruption and fetal death in utero and to investigate possible risk factors for their occurrence.
Observational retrospective study including the women having presented a placental abruption between January 2001 and January 2012, in a IIB maternity. Women's sociodemographic characteristics, clinical symptoms and the method used to detect placental abruption were collected. Patient data of those whose pregnancy resulted in fetal death were compared to those with more favorable outcomes.
There were 171 cases of placental abruption among 21,913 patients having delivered, which represents a 0.78% incidence. Diagnosis was rarely based on clinical data (30%). The rate of fetal death in utero represented 25% of the pregnancy's outcomes. A history of fetal death in utero increased the risk of placental abruption (P<0.001). This complication was more frequent for patients who did not have pregnancy monitoring (P=0.054) and before 37 weeks of amenorrhoea (P=0.005).
Placental abruption is an important cause of perinatal mortality and maternal morbidity. Among the observed risk factors, only regular pregnancy monitoring can be an easy way to prevent these complications.
描述胎盘早剥及胎儿宫内死亡的流行病学、临床和预后因素，并调查其发生的可能危险因素。
一项观察性回顾性研究，纳入2001年1月至2012年1月在一家IIB级产科发生胎盘早剥的女性。收集了女性的社会人口学特征、临床症状以及用于检测胎盘早剥的方法。将妊娠导致胎儿死亡的患者数据与结局较好的患者数据进行比较。
在21913例分娩患者中，有171例胎盘早剥病例，发病率为0.78%。诊断很少基于临床数据（30%）。胎儿宫内死亡率占妊娠结局的25%。胎儿宫内死亡史增加了胎盘早剥的风险（P<0.001）。这种并发症在未进行孕期监测的患者中更常见（P=0.054），且在闭经37周之前更常见（P=0.005）。
胎盘早剥是围产期死亡和孕产妇发病的重要原因。在所观察到的危险因素中，只有定期进行孕期监测是预防这些并发症的简便方法。
