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: 699 relevant articles (7 outcomes, 61 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pre-Eclampsia (Preeclampsia)
2.	Fetal Growth Retardation (Intrauterine Growth Retardation)
3.	Rupture
4.	Premature Birth (Birth, Premature)
5.	Disseminated Intravascular Coagulation

Experts

1.	Sheiner, Eyal: 6 articles (09/2015 - 09/2004)
2.	Heinonen, Seppo: 6 articles (12/2013 - 12/2004)
3.	Ananth, Cande V: 6 articles (01/2013 - 03/2002)
4.	von Dadelszen, Peter: 4 articles (03/2015 - 07/2002)
5.	Lockwood, Charles J: 4 articles (12/2012 - 09/2005)
6.	Levy, Amalia: 4 articles (05/2011 - 09/2004)
7.	Keski-Nisula, Leea: 4 articles (01/2008 - 12/2004)
8.	Punnonen, Kari: 4 articles (01/2008 - 12/2004)
9.	Toivonen, Sari: 4 articles (01/2008 - 12/2004)
10.	Helisalmi, Seppo: 4 articles (01/2008 - 12/2004)

Drugs and Biologics

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

1.	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." 01/01/2006 - "To evaluate the efficacy of a combined 2nd-trimester maternal serum homocysteine and uterine artery Doppler screening at 20 weeks of gestation for complications of pregnancy: preeclampsia, isolated intrauterine growth restriction (IUGR), placental abruption, and stillbirths. " 09/01/2007 - "Univariate analyses showed the following significant risk factors for placental abruption: preterm pre-labor rupture of the membranes (PRE-PROM; odds ratio (OR) 4.79, 95% confidence interval (CI) 1.52-15.08), non-compliance with antenatal care (OR 2.93, 95% CI 1.06-8.90), severe intrauterine growth restriction (IUGR), and elevated homocysteine levels (OR 45.55, 95% CI 7.05-458.93). "
2.	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. " 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). " 06/01/1995 - "We found no increased risk for abruptio placentae or increased perinatal mortality in women taking low-dose aspirin."
3.	Fibrinogen (Factor I)FDA Link 05/01/2015 - "Coagulopathy and placental abruption: changing management with ROTEM-guided fibrinogen concentrate therapy." 05/01/2015 - "Coagulopathy and placental abruption: changing management with ROTEM-guided fibrinogen concentrate therapy." 07/01/2014 - "As a comparison of fibrinogen synthesis, these women were compared with 25 women with placental abruption. " 01/01/1996 - "It is obvious that fibrinogen is an extremely important factor in maintaining pregnancy, and we conclude that fibrinogen level must be at least 60 mg/dl during pregnancy, 120 mg/dl during surgery and 150 mg/dl during labor, if possible as high as 200 mg/dl under the continuous infusion of fibrinogen to prevent placental abruption." 01/01/1996 - "The fibrinogen level before labor was 96 mg/dl, but decreased to 33 mg/dl when placental abruption was diagnosed. "
4.	Protein CIBA 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." 12/01/1998 - "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 - "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. "
5.	Magnesium Sulfate (Sulfate, Magnesium)FDA LinkGeneric 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). " 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. " 01/01/1998 - "The association between neonatal mortality and magnesium sulfate was not altered by maternal infection, gender, maternal race or ethnicity, maternal age, level of care, breech presentation, surgical delivery, corticosteroids, abruptio placentae, placenta previa, or bleeding on admission. " 10/01/2006 - "The groups were compared regarding the presence of severe pre-eclampsia, hemolysis elevated liver enzymes low platelets (HELLP) syndrome, eclampsia, placental abruption, hematological complications, renal failure, requirement for antihypertensive or magnesium sulfate treatments, cesarean section for acute fetal distress, birthweight, Apgar scores, perinatal mortality and neonatal morbidity including admission to the neonatal intensive care unit, respiratory distress syndrome, sepsis, convulsions, intracranial hemorrhage, hypoglycemia, hypocalcemia, and jaundice. "
6.	Adrenal Cortex Hormones (Corticosteroids)IBA 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). " 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. " 05/01/1993 - "Authors report a patient treated with corticosteroids for bronchial asthma who was afflicted by placental abruption at 24 weeks' gestation. " 01/01/1998 - "The association between neonatal mortality and magnesium sulfate was not altered by maternal infection, gender, maternal race or ethnicity, maternal age, level of care, breech presentation, surgical delivery, corticosteroids, abruptio placentae, placenta previa, or bleeding on admission. " 07/01/1999 - "A 36-year-old para 3 with early third-trimester severe preeclampsia, mild placental abruption, and fetal growth restriction, with a reassuring BPP of 8/8, was managed expectantly with intravenous magnesium sulfate, hydralazine, and intramuscular corticosteroids. "
7.	Acute fatty liver of pregnancyIBA 05/01/2007 - "The main associated conditions included abruptio placentae in 6 patients (24%), pregnancy-induced hypertension (PIH) in 5 (20%), amniotic fluid embolism in 4 (16%), acute fatty liver of pregnancy (AFLP) in 4 (16%), and HELLP syndrome in 3 (12%). " 01/01/2012 - "We describe here a primigravida with acute fatty liver of pregnancy and a multipara with placental abruption who each developed uterine inertia complicated by postpartum DIC that required total hysterectomy. " 11/01/2015 - "Several important-albeit not necessarily common-obstetric disorders associated with DIC include placental abruption, amniotic fluid embolism, sepsis syndrome, and acute fatty liver of pregnancy. " 11/01/1994 - "Acute fatty liver of pregnancy should be suspected in all patients with symptoms of preeclampsia in the presence of hypoglycemia, low fibrinogen, and prolonged prothrombin time, particularly in the absence of severe abruptio placentae. " 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). "
8.	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). "
9.	Terbutaline (Brethaire)FDA LinkGeneric 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.	Epoxide HydrolasesIBA 12/01/2004 - "Low-activity haplotype of the microsomal epoxide hydrolase gene is protective against placental abruption." 12/01/2004 - "We wanted to determine whether genetic variability in the gene encoding microsomal epoxide hydrolase (EPHX) contributes to individual differences in susceptibility to the occurrence of placental abruption. "

Therapies and Procedures

1.	Tocolysis 12/01/2008 - "Exclusion criteria were placental abruption or previa, fetal anomaly incompatible with life, or maternal medical contraindication to 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. " 11/01/1988 - "Antibiotic infusion and prompt delivery should be instituted if an intrauterine infection occurs, and tocolysis is called for in cases of preterm labor in which intrauterine infection and abruptio placentae can be excluded. "
2.	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 secular trends of placental abruption (PA), the effects of demographic variables and the use of cesarean section (CS) associated with PA. " 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). " 11/01/2015 - "An emergency caesarean section was performed at 33 weeks' gestation due to placental abruption following the spontaneous onset of preterm labour. "
3.	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." 01/01/2015 - "The commonest indications for this operation was haemorrhage (placental abruption) 26 patients (36% ) followed by ruptured uterus in 18 patients (25%), prolonged and obstructed labour promoted uterine atony needing hysterectomy in 13 patients (18%). " 06/01/2001 - "As a matter of fact, we can affirm that, in all its clinical manifestations abruptio placentae is a more dangerous disease than the placenta previa, except in the complications of the discharge of the afterbirth and of the postpartum, where haemorrhage and uterus atony lead to a great number of hysterectomies."
4.	General Anesthesia 04/01/2015 - "Obstetric examination revealed premature placental abruption; emergent caesarean section was planned under general anesthesia. " 06/01/2000 - "The diagnosis of placental abruption was made and she underwent an emergency cesarean section (C/S) under general anesthesia. " 01/01/2015 - "However, it must be emphasized that this technique requires a multidisciplinary team, maternal general anesthesia, high surgery times and potential maternal risks such as placental abruption and increased maternal blood loss due to uterine atony. " 01/01/2006 - "Several significant decision-to-delivery interval predictors were identified: 1. abruptio placentae (-54 min), umbilical cord prolapse (-37 min), and fetal stress (-35 min); 2. general anesthesia (versus regional) (-15 min), 3. cesarean sections performed during night-time (-10 min), 4. seniority of the surgeon (-6 min), and 5. cervical opening (for each cm: -6 min). " 07/01/2012 - "We report a case of severe pre-eclampsia with abruptio placentae with intra-uterine fetal demise, complicated by pulmonary edema, managed under general anesthesia for caesarean section. "
5.	Kidney Transplantation 01/01/2015 - "Renal morbidity included kidney transplantation, chronic renal failure, hypertensive renal disease, etc. During the study period 99 354 deliveries met the inclusion criteria; 1.8% (n = 1807) occurred in patients with a diagnosis of placental abruption. "