Placenta abruption surface and perinatal outcome.

OBJECTIVE

To identify the relationship between the placenta abruption (PA) surface and the perinatal outcome.

METHODS

This prospective descriptive study was carried out from 1 February to 30 September 2014. We recruited all women whose delivery was complicated by PA with onset preceded by the presence of active fetal movement. PA surface was assessed by placental examination after delivery. Main outcome measures were gestational age, Apgar score, and location and percentage of PA. Data were analyzed using SPSS 17.0 Fisher's exact test was used for comparison.

RESULTS

PA occurred in 47 women (1.3%). Mean gestational age was 36.0 weeks. PA percentages varied between 5% and 60%. Detachment ≥45% was always associated with stillbirth and was significantly observed in central PA (p < 0.0002), while separation of 25-44% was associated with various degrees of neonatal asphyxia. Compared to marginal separation of the placenta, central separation was significantly associated with stillbirth (77.8% versus 10.5%, p < 0.0002) and perinatal death (88.9% versus 13.1%, p < 0.0001).

CONCLUSION

PA surface ≥45% was associated with stillbirth. This knowledge can be helpful in identifying the cause of stillbirth when PA is found. Central PA was significantly associated with poor perinatal outcome and PA surface ≥45%. Therefore, its diagnosis calls for rapid intervention.