Abruptio placentae--risk factors and outcome of the newborn

A total of 180 (0.21%) out of 85.177 deliveries were complicated by abruptio placentae (AP) during the period 1962-1981. Of these the obstetric records of 130 deliveries were retrospectively studied in order to elucidate risk factors for the occurrence of abruptio placentae as well as to find out factors influencing the outcome of the newborn. The control group consisted of 120 randomly chosen contemporary parturients. Preterm contractions during pregnancy seemed to be most significantly associated with the occurrence of abruptio placentae. Also mothers with gestational hypertension or pre-eclampsia, smokers and unmarried mothers seemed to run a more than two-fold risk of premature separation of the placenta, while twin pregnancy and high parity seemed to increase the risk only slightly. However, a history of abruptio placentae revealed an 11-fold risk of premature separation of placentae in subsequent pregnancy. The factors most significantly associated with favourable prognosis of the newborn were: duration of gestation, birth weight and the degree of separation of the placenta. However, degree of cervical dilatation, presentation, mode of delivery or the time interval between diagnosis of AP and delivery seemed to have only weak discriminative power between newborns who survived and those who were lost.