[Compared course of clinical, biologic, echographic and speedometric parameters in retroplancetal hematoma]

The authors have studied 27 cases of Abruptio Placentae (A.P.) (for an observation time of 15 months). These 27 patients where divided into 3 groups: 6 patients without pregnancy follow-up, 5 with a regular follow-up and 16 with an intensive pregnancy follow-up. In this last group following parameters were studied: blood pressure, proteinuria, uricemia, hematocrit, platelet count, FDP, plasma volume, Fetal (umbilical artery) and Maternal (uterine artery velocities with doppler reclude Fetal heart Rate. The total number of intra uterine death and post natal death remained very high: 15 over 27 cases. However this rate was lower in the intensive group, where 10 fetuses with were delivered safely. Studying the evolution of clinical, biological and ultrasonic parameters during the last month before the AP we tried to establish curves of their mean value (every week for the last 4 weeks and every day for the last week). Almost all parameters showed a late significant variation (in the last week). Two of them were modified in the last two days: (FDP and Fetal heart rate acceleration). Two of them were "positive" (in 60 p. 100 of cases) 3 of 4 weeks before the AP: Maternal Plasma volume decrease, Presence of a Notch on the uterine artery doppler curve. In conclusion fetal or neonatal death after AB remains high and even with an intensive follow-up 30 p. 100 of the cases cannot be predicted.