Clinical Finding and Fetal Heart Rate Monitoring of Patients with the Placental Abruption in our Hospital

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  • Matsuura Masahiko
    Department of Obstetrics and Gynecology, Nihon University School of Medicine
  • Azuma Hiromitsu
    Department of Obstetrics and Gynecology, Nihon University School of Medicine
  • Kobayasi Yusuke
    Department of Obstetrics and Gynecology, Nihon University School of Medicine
  • Ogawa Kohei
    Department of Obstetrics and Gynecology, Nihon University School of Medicine
  • Katoh Takasi
    Department of Obstetrics and Gynecology, Nihon University School of Medicine
  • Sasaki Sigetane
    Department of Obstetrics and Gynecology, Nihon University School of Medicine
  • Miyakawa Yasusi
    Department of Obstetrics and Gynecology, Nihon University School of Medicine
  • Yamamoto Tatsuo
    Department of Obstetrics and Gynecology, Nihon University School of Medicine
  • Makimoto Yumi
    Department of Pediatrics and Child Health, Nihon University School of Medicine

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Other Title
  • 当院における常位胎盤早期剥離の臨床的検討と胎児心拍モニター所見
  • 当院[日本大学医学部附属板橋病院]における常位胎盤早期剥離の臨床的検討と胎児心拍モニター所見
  • トウ イン ニホン ダイガク イガクブ フゾク イタバシ ビョウイン ニ オケル ジョウイ タイバン ソウキ ハクリ ノ リンショウテキ ケントウ ト タイジ シンパク モニター ショケン

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Abstract

Placental abruption is one of the representative diseases in obstetrics that can cause perinatal death and maternal death. We examined the clinical findings and Fetal Heart Rate (FHR) monitoring of patients with abruptio placental. Methods: We analyzed the patients in our hospital with abruptio placental over the course of 10 years, including the DIC score, placental ablation area and FHR pattern. Results: There were 47 cases of abruptio placental, including 28 cases (60%) with a good neonatal prognosis, 7 cases (15%) with poor prognosis, 12 cases (25%) of intrauterine fetal demise (IUFD) out of 6,430 deliveries. In the case of IUFD, the gestational age was significantly earlier, the placental abruption area was wider and the DIC score was higher than those with a good neonatal prognosis. The FHR baseline variability was normal for all cases with Apgar scores of 7 out of 10 points. The umbilical cord arterial blood pH value was significantly better and the placental abruption area was smaller, when the FHR baseline variability was maintained. Conclusions: To further understand why the placental abruption area is larger and the DIC increases in cases of IUFD, careful management is necessary. The placental ablation area was not increased and the umbilical cord arterial blood pH and neonatal prognosis was better, when the FHR baseline variability was maintained. We concluded that FHR monitoring is important for the early diagnosis of abruptio placental and improvement of the neonatal prognosis and that the grade of placental ablation area can be estimated by the FHR pattern.

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