Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan.
J Matern Fetal Neonatal Med. 2020 Nov;33(22):3775-3783. doi: 10.1080/14767058.2019.1585424. Epub 2019 Mar 8.
We examined the impact of the abruption severity and the onset-to-delivery time on the maternal and neonatal outcomes of cases of clinically diagnosed placental abruption (PA). We investigated 84 patients who were diagnosed with PA at our hospital from January 2009 to September 2017. We classified the patients with PA into three groups based on the extent of the abruption: (1) mild abruption, <20%; (2) moderate abruption, 20-49%; (3) severe abruption, ≥50%, which was defined by the attending obstetricians at the time of delivery. The neonatal outcome was measured by the umbilical artery pH and the maternal outcome was measured by the obstetric disseminated intravascular coagulation score (DIC score). The rate of hypertensive disorders of pregnancy in the moderate abruption group was significantly lower than that in other groups ( = .010). The umbilical artery pH was below 7.00 in 29 cases. The umbilical artery pH of the severe abruption group (6.92) was the lowest and was significantly lower in comparison to other groups (mild group [7.24], < .001; moderate group [7.11], < .05). There was a significant correlation between the onset-to-delivery time and the umbilical artery pH in the moderate group (R = -0.43). The maternal DIC scores in the three groups did not differ to a statistically significant extent. The severity of placental separation is significantly correlated with poor neonatal outcomes and there was a significant negative correlation between the onset-to-delivery time and the umbilical artery pH in moderate abruption.
我们研究了胎盘早剥严重程度和发病至分娩时间对临床诊断胎盘早剥（PA）产妇和新生儿结局的影响。我们调查了 2009 年 1 月至 2017 年 9 月在我院确诊为胎盘早剥的 84 例患者。我们根据胎盘早剥的程度将患者分为三组：（1）轻度胎盘早剥，<20%；（2）中度胎盘早剥，20-49%；（3）重度胎盘早剥，≥50%，由分娩时的主治产科医生定义。新生儿结局通过脐动脉 pH 值衡量，产妇结局通过产科弥散性血管内凝血评分（DIC 评分）衡量。中度胎盘早剥组妊娠高血压疾病的发生率明显低于其他组（=0.010）。有 29 例脐动脉 pH 值<7.00。重度胎盘早剥组的脐动脉 pH 值（6.92）最低，与其他组相比显著降低（轻度组[7.24]，<0.001；中度组[7.11]，<0.05）。中度组的发病至分娩时间与脐动脉 pH 值呈显著负相关（R=-0.43）。三组产妇的 DIC 评分无统计学差异。胎盘分离的严重程度与新生儿不良结局显著相关，中度胎盘早剥的发病至分娩时间与脐动脉 pH 值呈显著负相关。
