INTRODUCTION: Our aim was to compare perinatal outcomes of pregnancies complicated by placental abruption in preterm with near-term and term period.
METHODS: A retrospective case-control study was conducted in singleton pregnancies complicated by placental abruption after 20 weeks of gestation. Information extracted from the obstetric records included demographic information, obstetric history, gestational age, major risk factors for placental abruption, perinatal outcomes, and macroscopic and microscopic histologic analysis of the placenta and results compared between groups.
RESULTS: Of the 74 cases of placental abruption, 46 cases (62%) occurred at preterm period (<34 weeks of gestation) and 28 cases (38%) at near term or term period (≥34 weeks of gestation). There was no significant difference between groups in terms of obstetric history, risk factors for placental abruption and perinatal outcomes (p>0.05). Macroscopically, the incidence of couvelaire uterus was significantly higher after 34 weeks of gestation (p<0.05), while that extent of placental separation was similar between groups (p>0.05). The incidence of histological chorioamnionitis and/or deciduitis in the preterm group was significantly higher than that in the near term and term group (p<0.05), while that of placental thrombosis, infarction and necrosis were similar between groups (p>0.05).
DISCUSSION AND CONCLUSION: The present results suggest that the possible processes leading to placental abruption in preterm deliveries are different from those in near-term and term deliveries.