Abruptio Placentae (Placental Abruption)

Premature separation of the normally implanted PLACENTA from the UTERUS. Signs of varying degree of severity include UTERINE BLEEDING, uterine MUSCLE HYPERTONIA, and FETAL DISTRESS or FETAL DEATH.

Also Known As:

Networked: 1082 relevant articles (13 outcomes, 91 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pre-Eclampsia (Preeclampsia)
2.	Hypertension (High Blood Pressure)
3.	Perinatal Death
4.	Premature Obstetric Labor (Premature Labor)
5.	Fetal Growth Retardation (Intrauterine Growth Retardation)

Experts

1.	Ananth, Cande V: 11 articles (01/2022 - 03/2002)
2.	Sheiner, Eyal: 8 articles (05/2021 - 09/2004)
3.	Heinonen, Seppo: 8 articles (08/2018 - 12/2004)
4.	Williams, Michelle A: 7 articles (01/2021 - 01/2013)
5.	Erez, Offer: 6 articles (09/2022 - 08/2009)
6.	Paavonen, Jorma: 5 articles (07/2022 - 01/2006)
7.	Tikkanen, Minna: 5 articles (07/2022 - 01/2006)
8.	Wen, Shi Wu: 5 articles (01/2022 - 12/2008)
9.	D'Alton, Mary E: 5 articles (09/2021 - 10/2004)
10.	Romero, Roberto: 5 articles (01/2019 - 07/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Abruptio Placentae:

1.	Aspirin (Acetylsalicylic Acid)FDA LinkGeneric 06/01/1994 - "Low dose aspirin did cause a significant reduction (P = 0.008) in deaths from causes other than placental abruption. " 11/01/2020 - "As noted in the original trial, there was an increased risk of placental abruption in the aspirin group overall compared with placebo (P=.025). " 06/01/1995 - "No trial of low-dose aspirin in pregnancy had predefined criteria for the diagnosis of abruptio placentae, and abruption was not a primary outcome in any of the 11 trials. " 06/01/1995 - "Three criteria were used to select studies for inclusion: 1) Studies were designed as randomized or double-blind clinical trials; 2) aspirin was administered in doses of less than 200 mg/day; and 3) outcome data included the incidence of abruptio placentae and perinatal mortality. " 06/01/2003 - "There was no increase in the risk of placental abruption with aspirin (OR 0.98, 95% CI 0.79, 1.21). "
2.	Fibrinogen (Factor I)FDA Link 07/01/2016 - "The present study sought to determine if the pre-delivery fibrinogen level could predict adverse maternal or neonatal outcomes in patients with placental abruption. " 12/18/2022 - "We suggest that the implementation of maternal fibrinogen in patients with placental abruption is a prognostic factor for serious fetal acidemia at delivery." 08/01/2019 - "Women with placental abruption exhibited more severe coagulopathy and required higher doses of fibrinogen concentrate than women who bled due to other causes. " 07/01/2016 - "Pre-delivery fibrinogen can predict adverse maternal as well as neonatal outcomes with placental abruption. " 07/01/2016 - "Pre-delivery fibrinogen predicts adverse maternal or neonatal outcomes in patients with placental abruption."
3.	HomocysteineIBA 02/01/2008 - "Women with placental abruption should be screened for thrombophilic factors and plasma homocysteine should be measured. " 09/01/2007 - "In this high-risk population, PRE-PROM and elevated homocysteine levels appear to represent the major risk factors for placental abruption." 04/01/2001 - "Clotting disorders and placental abruption: homocysteine--a new risk factor." 02/19/2019 - "Maternal plasma homocysteine concentration was significantly associated (linearly) with an increased risk of both the composite outcome of any placenta-mediated complication (p = 0.0007), SGA (p = 0.0010), severe SGA, and marginally with severe preeclampsia, but not preeclampsia, placental abruption and pregnancy loss. " 02/19/2019 - "Homocysteine is an intermediate metabolite implicated in the risk of placenta-mediated complications, including preeclampsia, placental abruption, fetal growth restriction, and pregnancy loss. "
4.	Magnesium Sulfate (Sulfate, Magnesium)FDA LinkGeneric 01/01/2016 - "Objective To evaluate the efficacy and safety of magnesium sulfate in the resolution of vaginal bleeding and contractions in nonsevere placental abruption. " 08/01/2000 - "Magnesium sulfate exposure was associated with decreased risk (OR 0.13, CI 0.03-0.66) after exclusion of premature rupture of the membranes and abruptio placentae. " 11/01/1998 - "However, the preterm birth group received magnesium sulfate tocolysis more frequently (31% vs 7%) and had a significantly greater rate of peripartum complications, such as rupture of membranes and abruptio placentae, than the group of patients who delivered at term (46.2% vs 12.5%, P <.05). " 01/01/2022 - "A total of 981 cases were investigated, of whom 55 were found with 1 min Apgar scores less than 7. The nomogram was set for the predicting model with larger area under the receiver operating characteristic curve, of which is 0.742(95% confidence interval = 0.670-0.805) in very preterm birth, with the variables of first and second labor stage(> = 1.6 hours), birthweight and MgSO4(magnesium sulfate), and is 0.807(95% confidence interval = 0.776-0.837) in late preterm birth, with the variables of second labor stage(> = 1.23 hours), birthweight, a history of previous cesarean delivery, fetal distress and placental abruption. " 03/01/1995 - "During the treatment period for those with a gestational age of less than 34 weeks, there were two patients with abruptio placentae in group I and the treatment periods were noted to be longer in group II than in group I. From the results of monitoring serum magnesium level in group I, when therapeutic level was achieved, magnesium sulfate induced great discomfort which might have led to the deterioration of the patients' condition. "
5.	Protein CIBA 12/01/1998 - "Resistance to activated protein C and the leiden mutation: high prevalence in patients with abruptio placentae." 10/01/1999 - "Activated protein C is effective for disseminated intravascular coagulation associated with placental abruption." 12/01/2010 - "A decrease in protein C was associated with an increased risk for abruption, suggesting an important role for the physiologic anticoagulant system in the etiology of placental abruption." 12/01/2010 - "The Normal anticoagulant system and risk of placental abruption: protein C, protein S and resistance to activated protein C." 01/01/1999 - "Protein C, Protein S and Antithrombin III were screened in one hundred patients admitted for abruptio placentae and one hundred women who delivered normally in Dakar university hospital. "
6.	fibrin fragment D (D-dimer)IBA 08/01/1993 - "The D-dimer slide test may be a superior rapid method to improve early diagnosis of abruptio placentae." 08/01/1993 - "Patients in the abruptio placentae group were significantly more likely to have a positive D-dimer slide test result than those in the non-abruptio placentae groups (p = 0.0001). " 08/01/1993 - "The likelihood of a positive D-dimer test result was not significantly different among patients in the non-abruptio placentae groups (p = 0.454). " 10/01/1995 - "D-dimer levels may be predictive for some complications such as preeclampsia (10) and they have been also reported to be useful for diagnosis of abruptio placentae (6). " 02/01/1993 - "Patients with preterm labor, preeclampsia, and abruptio placentae had mean D-dimer values significantly greater than those of controls (P < .003). "
7.	Salicylic Acid (2 Hydroxybenzoic Acid)FDA LinkGeneric 11/01/2020 - "Finally we present the CHASAP (Chronic Hypertension and Acetyl Salicylic Acid in Pregnancy) trial (NCT04356326), a multicentric prospective randomized double-blind superiority trial, which will compare, in pregnant women with chronic hypertension, the efficacy of low dose aspirin (150 mg/day) with a placebo, in the prevention of maternal-fetal morbidity and mortality (preeclampsia, placental abruption, IUGR, perinatal death, maternal death, and preterm delivery)."
8.	Adrenal Cortex Hormones (Corticosteroids)IBA 08/01/2023 - "We present a case of placental abruption leading to preterm delivery in a pregnancy complicated by Strongyloides stercoralis hyperinfection syndrome following antenatal corticosteroid use. " 01/01/2021 - "Using a SAS macro (SAS Institute, Inc., Cary, North Carolina) we developed, our approach is illustrated to assess the separate effects of exposure to inhaled corticosteroids and placental abruption on low birth weight mediated by prematurity. " 10/01/2008 - "After we controlled for variables that were clinically relevant, logistic regression analysis demonstrated that ultrasound evidence of severe neonatal cerebral lesions was associated independently with antenatal administration of corticosteroids (adjusted odds ratio, 0.3; 95% CI, 0.11-0.88; P = .03) and occurrence of placental abruption (adjusted odds ratio, 5.4; 95% CI, 1.4-20.7; P = .02). " 06/20/2016 - "Specially trained personnel from each cooperative units filled in the unified form in a standardized format to record the gender, gestational age, birth weight, PROM, placental abruption, antenatal corticosteroid, Apgar score, amniotic fluid pollution, and complications of the infants. " 10/01/2011 - "There were no significant differences in the gender, the percentage of twins, the percentage of the younger one in twins, maternal age, the percentage of using antenatal corticosteroids, the percentage of premature rupture of membranes, the percentage of placental abruption, the delivery mode and the fertilization mode in preterm infants with different severities of RDS. "
9.	Tocolytic Agents (Tocolytics)IBA 06/01/1999 - "In the abruptio placentae group 95 women (73%) were treated with tocolytic agents. " 11/01/1997 - " Specific risk factors identified in the literature are use of tocolytic agents in patients with multiple gestations, pre-eclampsia and eclampsia, abruptio placentae, and cesarean delivery. " 01/01/1998 - "This acute lung injury syndrome was observed to be associated with a variety of complications of pregnancy including premature labor, the use of tocolytics, infection, hypertension, leukoagglutinin reactions, aspiration, abruptio placentae, and amniotic fluid embolism. " 03/01/1989 - "Because some serious complications were reported when a terbutaline intravenous bolus (0.25 mg) was used as a tocolytic, we assessed its safety and efficacy when used in patients not affected by cardiovascular disease, tachycardia greater than 100 beats/min, thyrotoxicosis, fluid overload, corticoids, atropine, or severe abruptio placentae. "
10.	Fibrin Fibrinogen Degradation ProductsIBA 07/19/1969 - "The levels of fibrin, fibrinogen degradation products (F.D.P.) in the serum were investigated in normal pregnancy and parturition, after caesarean section, and in patients with abruptio placentae, eclampsia, intrauterine death, and post-partum haemorrhage. " 07/01/2014 - "Fibrinogen regeneration with placental abruption was rapid, whereas it remained depressed for 4-5 days with acute fatty liver of pregnancy; fibrin-fibrinogen split products were also cleared more rapidly after abruption than women with acute fatty liver (P<.001 for interaction for both using random effects modeling). " 01/01/2021 - "Pre-delivery laboratory findings suggest that the white blood cell count, hemoglobin, hematocrit, platelet count, albumin, aspartate aminotransferase (AST), creatinine, prothrombin time (PT), prothrombin activity, prothrombin time - international standardization ratio (INR), D-dimer, fibrinogen (FIB), and fibrin degradation products (FDP) changed significantly with increasing placental abruption severity. "

Therapies and Procedures

1.	Prenatal Care (Care, Prenatal) 11/01/2021 - "Risk factors for outborn delivery were gestational age <26 weeks (adjusted relative risk (aRR) 1.37, 95% confidence interval (CI) 1.13, 1.66), inadequate antenatal care (aRR 1.39, 95% CI 1.10, 1.81), placental abruption (aRR 1.66, 95% CI 1.27, 2.17), and increased distance to the closest level III unit ((aRR 2.79, 95% CI 2.00, 3.92) in the 4th versus 1st distance quartile). " 05/24/2021 - "Singleton extreme PTB risk factors included nulliparity, lack of prenatal care, and placental abruption. " 05/24/2021 - "In sub-populations (multiple gestations, women with previous PTB and indicated PTBs), risk factors included placental abruption and previa, lack of prenatal care, and recurrent pregnancy loss. " 10/07/2015 - "Clinicians should identify risk factors for abruptio placentae during prenatal care when managing pregnant women to prevent adverse maternal and foetal outcomes." 11/01/2010 - "Logistic regression analysis showed that lack of a regular antenatal care (OR = 45.348, 95%CI: 17.096 - 120.288, P = 0.000), FGR (OR = 27.087, 95%CI: 5.585 - 131.363, P = 0.000) and second/third trimester pregnancy loss (OR = 16.068, 95%CI: 1.698 - 152.029, P = 0.015) were independent risk factors with placental abruption. "
2.	Therapeutics 10/01/2012 - "After hemodynamic stabilization of the mother and control of the viability of the fetus the therapy of traumatic placental abruption consists mostly of an immediate caesarean section. " 09/01/1992 - "Although clinical suspicion of abruptio placentae remains a contraindication to betamimetic therapy, exceptions may be made if fetal and maternal well-being can be monitored and if a fully staffed operating room is always available for immediate cesarean delivery. " 01/01/2020 - "These include but are not limited to alterations in maternal physiology that occur with pregnancy, potential teratogenicity of pharmacologic therapies and diagnostic studies using ionizing radiation, need for fetal monitoring, Rh immunization status, placental abruption, and preterm labor. " 02/01/2023 - "Lessons from timing of ablation therapy for multi-drug refractory gestational atrial tachycardia with abruptio placentae: a case report." 09/01/1992 - "Betamimetic therapy is usually contraindicated for the treatment of premature labor associated with abruptio placentae. "
3.	Tocolysis 09/01/1992 - "A diagnosis of abruptio placentae was made, and because the maternal cardiovascular and fetal biophysical indices were normal, tocolytic therapy was started. " 04/01/1989 - "Forty-three patients with abruptio placentae before 35 weeks of pregnancy were managed expectantly with observation or with tocolytic therapy when contractions were present. " 06/01/1990 - "Fifteen patients were identified in a retrospective analysis of one institution's experience with the use of tocolysis in selected patients with an admission diagnosis of placenta previa or abruptio placentae. " 12/01/2008 - "Exclusion criteria were placental abruption or previa, fetal anomaly incompatible with life, or maternal medical contraindication to tocolysis. " 03/01/2003 - "However, cerebral lesions were found in preterm neonates after tocolysis who exhibited signs of infection (29 - 33 wk: PVL n = 2; 23 - 28 wk: ICH n = 1) and in preterm neonates without tocolysis who had undergone fetal hypoxia or abruptio placentae (29 - 33 wk: PVL n = 4; antenatal terminal vein bleeding n = 1; 23 - 28 wk: PVL n = 2; terminal vein bleeding n = 5; posterior cerebral artery bleeding n = 1). "
4.	Cesarean Section (Caesarean Section) 04/01/2015 - "The study group consisted of 36 pregnant women who underwent caesarean section with a diagnosis of placental abruption, while the control group comprised 36 pregnant women who underwent caesarean section due to obstetric reasons. " 01/01/2014 - "Women with caesarean section or placental abruption in their second pregnancy were not included in the study population. " 03/01/1996 - "To study national secular trends in Norway of perinatal mortality and case fatality to placental abruption (PA) and associations with cesarean section (CS). " 03/01/1996 - "To study secular trends of placental abruption (PA), the effects of demographic variables and the use of cesarean section (CS) associated with PA. " 07/01/2023 - "In the other 56 cases, therefore, emergency cesarean section was performed at the time of diagnosis of placental abruption. "
5.	Hysterectomy 01/01/2021 - "Symptoms and course of the eclamptic attack, maternal comorbidities, associated obstetric complications (placental abruption, surgical complications, blood loss, hysterectomy) and non-obstetric complications (coagulopathy, renal and hepatic impairment, neurological complications) were monitored. " 12/11/2017 - "Placental abruption leading to hysterectomy." 05/01/2011 - "Patients with placental abruption were more likely to have cesarean deliveries, as well as cesarean hysterectomy.Using" 11/01/2009 - "The most independent risk factors for emergency hysterectomy were multiparity (odds ratios (OR) 17.3, 95% confidence interval (95% CI) 8.7-34.6); caesarean delivery in index delivery (OR 6.7, 95% CI 3.8-11.9) and caesarean section for placental abruption (OR 3.8, 95% CI 0.4-33.4). " 11/01/2009 - "Our study suggests that multiparity, primary or repeat caesarean deliveries for placental abruption are independently associated risks for peripartum hysterectomy and uterine atony is the still most common indication for peripartum hysterectomy in Turkey."