Decision-to-delivery interval in suspected placental abruption – association with pregnancy outcome. (November 2014)

• Record Type: Journal Article
• Authors: Gabbay-Benziv, Rinat; Ashwal, Eran; Lahav-Ezra, Hila; Rabinerson, David; Wiznitzer, Arnon; Ben-Haroush, Avi; Yogev, Yariv
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 27:Number 16(2014)
• Page Start: 1680
• Page End: 1683
• Publication Date: 2014-11
• Subjects: Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2013.871703
• Languages: English
• ISSNs: 1476-7058

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objective</italic>: To determine the association between decision to delivery interval (DDI) and short-term perinatal outcome in cases of suspected placental abruption delivered by cesarean section (CS).</p> <p> <italic>Study design</italic>: A retrospective cohort study of all cases of placental abruption delivered by CS (2010–2012) in a single university affiliated tertiary center. Composite adverse neonatal and maternal outcome were assessed.</p> <p> <italic>Results</italic>: The rate of placental abruption was 0.5% (140/27 677 deliveries) and 65/140 (46%) were delivered by CS. Indications for CS were non-reassuring fetal heart rate (NRFHR) in 32/65 (49.3%), maternal bleeding 20/65 (30.7%) and other indications in 13/65 (20%). Obstetrical and labor characteristics were similar unrelated to the indication for CS. Gestational age at delivery was higher in the group operated due to NRFHR (36 ± 4.3, 34 ± 3.7 and 32 ± 4.1 weeks, respectively, <italic>p</italic> = 0.03). DDI was shortest when CS was due to NRFHR followed by CS due to maternal bleeding or other indications (23 ± 19, 30 ± 16, 50 ± 40 min, respectively, <italic>p</italic> = 0.001). The umbilical artery PH was lower in those who operated due to NRFHR (7.17 ± 0.17, 7.23 ± 0.06 and 7.30 ± 0.09, respectively, <italic>p</italic> = 0.002). The overall rate of neonatal and maternal composite outcome was 66% and 40%, respectively with no significant difference in relation to indication for CS.</p> <p> <italic>Conclusion</italic>: In cases of suspected placental abruption, fetal short-term morbidity is probably related to the indication for CS and not only to DDI.</p> </abstract>