Department of Obstetrics and Gynecology, Republic of Turkey Ministry of Health Ankara City Hospital, Ankara, Turkey.
Department of Obstetrics and Gynecology, Republic of Turkey Ministry of Health Adana City Hospital, Adana, Turkey.
Medicine (Baltimore). 2024 Jun 28;103(26):e38633. doi: 10.1097/MD.0000000000038633.
To analyze maternal and neonatal effects of placental abruption (PA) through a novel classification in the presence of hypertension. Initial hemoglobin parameters were also compared to predict pregnancy outcomes in addition to hypertension. This retrospective cohort designed study was conducted on 115 pregnant women with PA. The main parameters scanned and recorded from the hospital database and patient medical files. Two groups were classified regarding of presence or absence of hypertension (53 hypertensive, 62 normotensive). Maternal demographical and clinical characteristics (abdominal pain, vaginal bleeding) were recorded. APGAR scores below 5 at 1st and 5th minute, fetal or neonatal death, admission and length of stay in Neonatal Intensive Care Unit were also investigated and compared between the groups. Stillborn to live-born ratio and lower APGAR scores < 5 at 5th minute were significantly higher in hypertensive group than normotensive group (P = .006 and 0.047, respectively). Poor maternal outcomes were detected in the hypertensive group than normotensive group regarding rate of blood transfusion (27/53, 50.9%; 18/62, 29%, respectively, P = .017). More abdominal pain and less vaginal bleeding were seen in PA with HT. Higher lymphocyte count, mean platelet volume, and platelet distribution width were reported in hypertensive group. Poorer maternal and neonatal outcomes of hypertensive patients with PA were detected. These patients should deserve greater attention to assess not only the possible risks associated with abruption but also the accompanying complications.
通过高血压存在情况下的一种新分类方法,分析胎盘早剥(PA)的母婴影响。此外,还比较了初始血红蛋白参数以预测妊娠结局。本回顾性队列研究纳入了 115 例胎盘早剥孕妇。主要参数从医院数据库和患者病历中扫描和记录。根据是否存在高血压将两组分类(53 例高血压,62 例血压正常)。记录了产妇的人口统计学和临床特征(腹痛、阴道出血)。还调查和比较了两组之间 1 分钟和 5 分钟时 APGAR 评分低于 5、胎儿或新生儿死亡、入住新生儿重症监护病房和住院时间。高血压组的死产儿与活产儿比例以及 5 分钟时较低的 APGAR 评分<5 均明显高于血压正常组(P=0.006 和 0.047)。高血压组的产妇结局不良发生率高于血压正常组,表现为输血率(27/53,50.9%;18/62,29%,P=0.017)。高血压伴胎盘早剥患者的腹痛更多,阴道出血更少。高血压组的淋巴细胞计数、平均血小板体积和血小板分布宽度更高。检测到高血压合并胎盘早剥患者的母婴结局较差。这些患者应得到更多关注,不仅要评估与早剥相关的可能风险,还要评估伴随的并发症。