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Expectant management of abruptio placentae before 35 weeks gestation
A L Bond1, T G Edersheim, L Curry
1Department of Obstetrics and Gynecology, New York Hospital-Cornell Medical Center, NY 10021.
American Journal of Perinatology
|April 1, 1989
Summary
Expectant management for abruptio placentae before 35 weeks is feasible. Close maternal and fetal monitoring can lead to successful outcomes without intrauterine deaths in selected preterm pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Abruptio placentae is a significant cause of preterm birth and adverse perinatal outcomes.
- Management strategies for preterm abruptio placentae often involve delivery, but expectant management may be considered in select cases.
Purpose of the Study:
- To evaluate the feasibility and outcomes of expectant management for abruptio placentae diagnosed before 35 weeks of gestation.
Main Methods:
- A cohort of 43 patients with preterm abruptio placentae were managed expectantly.
- Management included observation or tocolytic therapy for contractions.
- Patients underwent antepartum fetal heart rate monitoring and serial laboratory tests.
Main Results:
- The mean time to delivery was 12.4 days.
- Twenty-three patients delivered within 1 week, while 20 delivered at a mean of 26.8 days.
- No intrauterine deaths occurred in the study population.
Conclusions:
- Expectant management is a reasonable approach for carefully selected patients with preterm gestation and low-grade abruptio placentae.
- Close maternal and fetal surveillance is crucial for successful expectant management.
- This approach can potentially improve perinatal outcomes by allowing for fetal maturation.