Abruptio Placentae is a serious obstetric condition characterized by the sudden, premature separation of the placenta from the uterine wall before the delivery of the fetus.
This can lead to severe bleeding, fetal distress, and potentially life-threatening complications for both the mother and the infant.
Early recognition and prompt management are critical to minimize the risk of adverse outcomes.
PubCompare.ai can help optimie your research protocols for this condition by providing easy access to the latest literature, preprints, and patent information, enabling you to identifty the best approaches and streamline your research process.
Most cited protocols related to «Abruptio Placentae»
We conducted the trial at three maternal–fetal surgery centers — the Children's Hospital of Philadelphia, Vanderbilt University, and the University of California, San Francisco — together with an independent data-coordinating center at George Washington University and with the Eunice Kennedy Shriver National Institute of Child Health and Human Development. All other fetalintervention centers in the United States agreed not to perform prenatal surgery for myelomeningocele while the trial was ongoing. The trial was approved by the institutional review board at each center. The study protocol, including the statistical analysis plan and full inclusion and exclusion criteria, is available with the full text of this article at NEJM.org. Inclusion criteria were a singleton pregnancy, myelomeningocele with the upper boundary located between T1 and S1, evidence of hindbrain herniation, a gestational age of 19.0 to 25.9 weeks at randomization, a normal karyotype, U.S. residency, and maternal age of at least 18 years. Major exclusion criteria were a fetal anomaly unrelated to myelomeningocele, severe kyphosis, risk of preterm birth (including short cervix and previous preterm birth), placental abruption, a body-mass index (the weight in kilograms divided by the square of the height in meters) of 35 or more, and contraindication to surgery, including previous hysterotomy in the active uterine segment.
Adzick N.S., Thom E.A., Spong C.Y., Brock JW I.I.I., Burrows P.K., Johnson M.P., Howell L.J., Farrell J.A., Dabrowiak M.E., Sutton L.N., Gupta N., Tulipan N.B., D'Alton M.E, & Farmer D.L. (2011). A Randomized Trial of Prenatal versus Postnatal Repair of Myelomeningocele. The New England journal of medicine, 364(11), 993-1004.
We generated descriptive statistics and bivariate associations for all variables and examined them for distributional normality. We used multiple linear regression and logistic regression to assess the effects of proximity to the WTC site and stage of pregnancy when the event occurred, on gestational duration, birth weight, birth length, head circumference, ponderal index, and sex-specific small size for gestational age (SGA) among term deliveries (Alexander et al. 1996 (link)). We excluded 10 women who were determined not to have been pregnant on 11 September 2001, based on the gestational age of the baby at birth and the date of delivery. In addition, only women who had completed 36 weeks and 6 days of gestation, or 258 days, and considered full term were included in the analyses, because preterm delivery may have other, complex etiologies. These criteria excluded a total of 29 women, for a final sample of 300 women. We included race/ethnicity (Asian, African American vs. all others) and Medicaid status (marker for poverty) as covariates in all analyses because of their potentially confounding effects on the relationship between exposure and birth outcomes. Other relevant covariates included infant sex, maternal height, prepregnancy weight, parity (0, ≥1), maternal age in years, cesarean section, and maternal medical complications (including preeclampsia, placental abruption, hypertension, and diagnosis of diabetes during the pregnancy). Smoking was not included because enrollment criteria required that women be nonsmokers during their entire pregnancy. In this cohort, sexually transmitted disease and alcohol use (self-report by interview yielded very low use) were not significantly associated with exposure or birth outcomes (p > 0.05), and their inclusion did not alter effect sizes. Therefore, we excluded them to limit the number of independent variables. All analyses were done using SPSS version 11.5 (SPSS Inc., Chicago, IL).
Lederman S.A., Rauh V., Weiss L., Stein J.L., Hoepner L.A., Becker M, & Perera F.P. (2004). The Effects of the World Trade Center Event on Birth Outcomes among Term Deliveries at Three Lower Manhattan Hospitals. Environmental Health Perspectives, 112(17), 1772-1778.
Observational studies using case control and cohort designs that reported one or more of the pre-specified primary and/or secondary outcomes for maternal age <35 (control) and ≥35 years (AMA) populations were included. Primary outcomes were stillbirth (according to individual study gestational age cut off) and fetal growth restriction (FGR) defined as birthweight below 5th centile adjusted for gestational age [17 (link)] Secondary outcomes were neonatal death (NND), small for gestation age (SGA; defined as a birthweight below 10th centile adjusted for gestational age or related definitions specified by authors), neonatal intensive care unit (NICU) admissions and neonatal acidosis (umbilical artery pH <7.0–7.2), preeclampsia (blood pressure ≥140/90 with significant proteinuria or as classified by authors where definition was not provided), placental abruption (classified by authors), preterm birth (PTB) <37 weeks gestation and gestational diabetes mellitus (GDM). Where authors stated different definitions of outcomes, data were re-classified in line with definitions stated (e.g. if authors defined FGR as <10th Centile this was re-classified as SGA in these analyses). Where definitions of classifications were not stated, authors’ classifications were accepted. Where possible, extracted data was sub-divided by parity (primiparous and multiparous mothers). Where reported, data regarding the frequency of maternal co-morbidities (obesity, hypertension and diabetes) and use of ART were extracted. Duplicate studies were removed and the papers were excluded if they: were case reports, were restricted to multiple pregnancies or did not separate data from multiple pregnancies from singletons, primarily reported the success rates of assisted reproductive technologies or pre-existing medical conditions as a primary outcome, focused on chromosomal abnormalities or substance abuse, relevant data could not be extracted or were review papers. Reports on rising Cesarean section rates with AMA were not included as a systematic review was recently conducted on this topic [12 (link)] The initial search was conducted by one investigator (SL) and validated by a secondary conductor (HD) to ensure accuracy of search and application of exclusion criteria.
Lean S.C., Derricott H., Jones R.L, & Heazell A.E. (2017). Advanced maternal age and adverse pregnancy outcomes: A systematic review and meta-analysis. PLoS ONE, 12(10), e0186287.
We did this prospective, active-controlled, observer-blind, randomised phase 4 trial at six referral centres and community health centres in Bamako, Mali. In the year before starting the trial, influenza activity occurred from September to April, with peaks in October and February. Third-trimester pregnant women (≥28 weeks' gestation based on last menstrual period, ultrasound, or uterine height) presenting to participating health centres for prenatal care were eligible for inclusion. Participants had to be able to understand and comply with planned study procedures, provide written informed consent before initiation of any study procedures, and intend to reside in the study area until their newborn infants were 6 months old. Participants could not be members of a household that already had a woman who was participating or had participated in this study. Other exclusion criteria were a history of severe reactions following previous immunisation with influenza or meningococcal vaccines; Guillain–Barré syndrome; known allergy or hypersensitivity to eggs, egg proteins, latex, diphtheria toxoid, or any other components of trivalent inactivated influenza vaccine (Vaxigrip) and quadrivalent meningococcal conjugate vaccine (Menactra); known chronic medical disorder that, in the judgment of the investigator, could compromise assessment of the study vaccine or put the participant at risk; known active infection with HIV, hepatitis B virus, or hepatitis C virus; complications with the ongoing pregnancy, including preterm labour (with cervical change), placental abruption, premature rupture of membranes, known major congenital anomaly, or pre-eclampsia; acute illness or an oral temperature greater than or equal to 37·8°C within 72 h of vaccination (resulted in a temporary delay of vaccination); receipt of any other vaccine, excluding tetanus toxoid, within 2 weeks (for inactivated vaccines) or 4 weeks (for live vaccines and meningococcal A conjugate vaccine) before vaccination in this study; receipt of immunoglobulins or any blood products within 30 days before administration of study vaccines; chronic administration of immunosuppressants or other immune-modifying drugs within 90 days before administration of study vaccines; or any disorder that, in the opinion of the investigator, might compromise the wellbeing of the participant or compliance with study procedures, or interfere with the assessment of study vaccines. We additionally excluded women who intended to travel out of the study area in the 40 days after delivery. Enrolment continued until the requisite number of laboratory-confirmed influenza cases was detected in infants born to vaccinated women. Approval for the research was obtained from the University of Maryland, Baltimore Institutional Review Board; the ethics committee of the Faculté de Médecine, Pharmacie et Odonto-Stomatologie of Mali; and the Ministry of Health of Mali. Community sensitisation was achieved through community leaders, health centre representatives and community members who attended community-wide meetings. All participants provided informed consent. If the participant was illiterate, consent was obtained in the presence of a literate witness after listening to the audiotaped version of the consent form in Bambara, the local language.
Tapia M.D., Sow S.O., Tamboura B., Tégueté I., Pasetti M.F., Kodio M., Onwuchekwa U., Tennant S.M., Blackwelder W.C., Coulibaly F., Traoré A., Keita A.M., Haidara F.C., Diallo F., Doumbia M., Sanogo D., DeMatt E., Schluterman N.H., Buchwald A., Kotloff K.L., Chen W.H., Orenstein E.W., Orenstein L.A., Villanueva J., Bresee J., Treanor J, & Levine M.M. (2016). Maternal immunisation with trivalent inactivated influenza vaccine for prevention of influenza in infants in Mali: a prospective, active-controlled, observer-blind, randomised phase 4 trial. The Lancet. Infectious Diseases, 16(9), 1026-1035.
We identified publications investigating the association between pre-eclampsia and at least one risk factor in a previous pregnancy or in the current pregnancy. We examined those risk factors described in the published guidelines and reviews13 (link) 14 (link) 15 (link) 16 (link) 17 (link) 18 (link) 19 (link) that were patient specific, that were readily recalled by a woman or abstracted from her prior pregnancy record, and that a general clinician could ascertain in the first trimester of pregnancy. For these reasons, and the observation that a family history in risk assessment tends to have a low sensitivity (that is, low recall),20 (link) we did not assess family history of pre-eclampsia as a risk factor. We also limited our selection to large sample cohort studies because they tend to be more representative of the general population than small single centre studies and they have sufficient statistical power to assess less prevalent, but potentially important, risk factors.21 (link) Selected risk factors from a previous pregnancy included a history of pre-eclampsia, placental abruption, fetal intrauterine growth restriction, and stillbirth. Current pregnancy risk factors included nulliparity, advanced maternal age, high body mass index (BMI), chronic hypertension, prepregnancy diabetes mellitus (type 1 or type 2), chronic kidney disease, systemic lupus erythematosus, antiphospholipid antibody syndrome, assisted reproduction, and multiple pregnancy. The resulting papers were first screened by title and abstract. Full text articles were obtained if they met all of the following screening criteria: a cohort study design with a minimum sample size of 1000 pregnancies; the study evaluated the relation between one or more of the aforementioned risk factors and the outcome of pre-eclampsia; the authors provided the number of pre-eclampsia events among their participants with and without a given risk factor, to enable the calculation of pooled effect sizes, as described below. Full text papers were included in the final dataset if they met the aforementioned screening criteria and also evaluated each risk factor up to 16 weeks’ gestation or earlier (as aspirin might be more efficacious when initiated before this gestational age6 (link) 7 (link) 8 (link)). Two authors (EB and KM), both of whom are medical students, screened studies and abstracted data. EB screened all citations retrieved from the database searches, and both authors evaluated the eligibility of the full text articles. Disagreements were resolved by discussion or in consultation with a third author (JGR). If two published studies evaluated the same cohort of women, we included the study with the largest number of women or the greatest number of relevant outcomes. Study authors were not contacted.
Bartsch E., Medcalf K.E., Park A.L, & Ray J.G. (2016). Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. The BMJ, 353, i1753.
This retrospective study reviewed medical charts was performed in a center for maternal, fetal, and neonatal medicine in Haseki Training and Research Hospital, with 89 pregnant women admitted with placental abruption. There were 7077 pregnant women who were delivered between 2016 and 2020 in the study period. The approval of the Haseki Training and Research Hospital Clinical Research Ethics Committee was obtained for this study (date: August 04, 2021, number: 62-2021) and the valid Helsinki Declaration. At the first admission, the diagnosis of placental abruption was confirmed primarily on ultrasonographic examination or one or more of the following clinical features, including uterine tenderness, abdominal pain, and vaginal bleeding or with or without abnormal fetal heart activity. Placental abruption was reconfirmed during cesarean delivery by local examination of the placenta for separation and the presence of a retroplacental hematoma. The suspected placenta was sent to the Pathology Laboratory to confirm the presence of the abruption. Medical charts of the study participants for this period were screened for baseline clinical, obstetric and ultrasonographic features, presence of stillbirth, pre-and post-delivery laboratory results, required transfusion and its amount, and neonatal outcomes of women with placental abruption with or without stillbirth were collected. A composite poor maternal outcome was recorded if any of the following features were present: hemorrhagic shock and DIC. The results of the hemogram tests, which are the targeted parameters of the study and routinely applied both at admission and 4 h postoperatively, were recorded. Exclusion criteria included clinical conditions, including known acute or chronic maternal infections, hematological disorders (disorders affecting thrombocyte function and hematological cancers), and chronic systemic disorders affecting the results of complete blood count.
Guleroglu F.Y., Ekmez M., Atas B.S, & Cetin A. (2023). Value of hematological indices NLR, PLR, and MPV to determine the clinical outcome of placental abruption in women regarding stillbirth. Northern Clinics of Istanbul, 10(1), 40-47.
Statistical analyses were performed using Stata version 17.0 (StataCorp) and R version 4.1.2 (R Project for Statistical Computing) with a specified 2-tailed α level of .05. We report birthing parent demographic variables using descriptive statistics stratified by newborn drug test order. The rate of newborn drug test orders was stratified by race and ethnicity, by year during the study period (2014-2020), before and after recreational cannabis legalization, and by prenatal urine drug test order and result. We used logistic regression models to compare newborn drug test incidence estimates including race or ethnicity, the stratifying variable (time or urine drug test), and the interaction as covariates. We performed univariate analysis using logistic regression for newborn drug test order with demographic variables and diagnostic variables related to tobacco, alcohol, opioid, substance use, placental abruption, and prenatal urine drug test results as single covariates. Adjusted associations were evaluated by including all covariates in the same model. Interactions between race or ethnicity and other covariates were assessed and retained if significant. We performed secondary analyses to assess how cannabis legalization affected associations by including a dichotomous indicator for births occurring before and after legalization date interacting with key variables. We analyzed newborn drug test results by comparing the proportion of positive tests for each substance class across race and ethnicity groups. We then used a logistic regression model with THC result as the outcome and a dichotomous indicator for births occurring before or after legalization as a covariate. All models were run under a generalized estimating equation (GEE) framework to account for correlations present between multiple deliveries for the same birthing parent during the study period. Models assumed an exchangeable correlation matrix and estimated robust standard errors.
Schoneich S., Plegue M., Waidley V., McCabe K., Wu J., Chandanabhumma P.P., Shetty C., Frank C.J, & Oshman L. (2023). Incidence of Newborn Drug Testing and Variations by Birthing Parent Race and Ethnicity Before and After Recreational Cannabis Legalization. JAMA Network Open, 6(3), e232058.
This study was approved by the Reproductive Medicine Ethics Committee of Chengdu Jinjiang Hospital for Maternal & Child Health Care (approval number: 2019003) and followed the Helsinki Declaration. All participants were informed of the nature of the study and signed a written informed consent before participation. The participants were recruited between Oct 2020 and Mar 2022, including unpregnant (UP), normally pregnant (NP), and SA women. Intrauterine pregnancy was diagnosed through serum and urine β-human chorionic gonadotropin (β-hCG) tests and Doppler ultrasound, and the SA was diagnosed as the unintentional end of pregnancy. The inclusion criteria were: (1) less than 35 years old, body mass index (BMI) < 28 kg/m2, and no history of smoking and drinking in the three months before endometrial collection (UP women) or during this pregnancy (NP and SA women); (2) for participants in UP and NP groups, no history of adverse pregnancy (such as SA, premature delivery, pregnancy-induced hypertension, placental abruption), hypertension, cryptorrhea (such as diabetes), and immune and infectious diseases; for participants in SA group, experienced at least one SA before this pregnancy, no normal childbearing history, and no use of immunomodulators and anticoagulants during this pregnancy; (3) no anatomical abnormalities of uterine, such as septate, unicornate, bicornate and didelphis uteri, were observed in the ultrasound examination before participation; (4) the UP volunteers agreed to donate endometrial tissue one week after ovulation, the NP women chose to terminate the healthy pregnancies voluntarily, and the SA women selected induced abortion after the demised fetus was confirmed; (5) no chromosomal abnormalities were identified in the aborted tissues; (6) the days of pregnancy (DOP) in NP and SA women were 42 to 70 days. As a result, 43 participants were recruited, including 10, 15, and 18 in the UP, NP, and SA groups, respectively, and the general characteristics are shown in Table S1.
Ye H., Li L., Dong Y., Zheng Q., Sha Y., Li L., Yang P., Jia Y, & Gu J. (2023). Dysregulated low-density granulocyte contributes to early spontaneous abortion. Frontiers in Immunology, 14, 1119756.
All women were grouped according to three bases: age, parity, and a mixture of age and parity. According to age, pregnant women were divided into five groups: the first appropriate age group (20–24 years, A1 group), the second appropriate age group (25–29 years, A2 group), the third appropriate age group (30–34 years, A3 group), the advanced maternal age group (35–39 years old, AMA group), and the very advanced maternal age group (≥40 years, vAMA group). For parity, pregnant women were divided into two groups: a nulliparous group (parity = 1) and a multiparous group (parity ≥ 2). With regard to the mixture of age and parity, pregnant women were divided into 10 groups, combining the two previous groupings. Education was categorized into bachelor’s degree or above and no bachelor’s degree. Residence was divided into urban and rural areas. Marital status was divided into married and unmarried. Smoking was divided into Yes and No. Pre-pregnancy BMI was calculated by dividing pre-pregnancy weight (kg) by the square of height (m2). BMI was divided into four categories using Asian-specific cut-offs (17 (link)): <18.5, 18.5–23, 23–27.5, and ≥27.5 kg/m2. Gestational weight gain (GWG) was classified following the 2009 Institute of Medicine (IOM) guidelines, the standard divides GWG into Inadequate, Adequate, and Excessive according to different prenatal weight standards for pregnant women (18 ). Pregnancy was divided into two categories: assisted reproduction and natural conception. Gestational weeks were separated into three categories: 28–31, 32–36, and 37 weeks and above, with deliveries at less than 37 weeks being considered as preterm births. For multiparas, the form of the previous birth was classified into cesarean section and vaginal delivery. The outcome indicators were maternal pregnancy outcomes and neonatal outcomes. Maternal pregnancy outcomes included gestational hypertension, eclampsia/pre-eclampsia, gestational diabetes mellitus (GDM), intrahepatic cholestasis of pregnancy (ICP), anemia, placenta previa, placental abruption, placental implantation, premature rupture of membranes, postpartum hemorrhage, oligohydramnios, preterm birth, and cesarean section. Neonatal outcomes included macrosomia, fetal distress, transfer to the neonatal unit, neonatal jaundice, and an Apgar score <7 within 5 min of birth. All outcome indicators were diagnosed according to the International Classification of Diseases 10th edition (ICD-10).
Dai J., Shi Y., Wu Y., Guo L., Lu D., Chen Y., Wang Y., Lai H, & Kong X. (2023). The interaction between age and parity on adverse pregnancy and neonatal outcomes. Frontiers in Medicine, 10, 1056064.
Maternal baseline information was derived from the electronic database of the hospitals, including sociodemographic characteristics and reproductive history. We further abstracted the ART procedures and most of the perinatal outcomes from the database of the hospitals, while the neonatal morbidity and mortality were followed up and recorded by well-trained clinical personnel. The pregnancy outcomes assessed included hypertensive disorders in pregnancy (HDP), GDM, Intrahepatic cholestasis of pregnancy (ICP), placental abruption, placenta previa, oligohydramnios, premature rupture of membrane (PROM), postpartum hemorrhage (PPH) and mode of delivery. While neonatal outcomes were assessed including the gender of neonates, birth weight, preterm birth (PTB), weight for gestational age, neonatal infection, admission to the neonatal intensive care unit (NICU), neonatal asphyxia, neonatal jaundice, and congenital anomaly. Preterm birth was defined as delivery at less than 37 weeks, and very preterm was defined as delivery of baby between 28 and 32 gestational weeks of pregnancy. LGA or SGA was defined as a birth weight more than 90th centile or less than 10th centile of our population for a specific gestational age and sex, respectively (19 (link), 20 (link)). Diagnoses were coded according to the International Classification of Diseases version 10(ICD-10).
He Y.C., Su K.Z., Cai J., Meng Q.X., Wu Y.T, & Huang H.F. (2023). Serum anti-Müllerian hormone levels are associated with perinatal outcomes in women undergoing IVF/ICSI: A multicenter retrospective cohort study. Frontiers in Endocrinology, 14, 1081069.
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The main symptoms of Abruptio Placentae include sudden, severe vaginal bleeding, abdominal pain, uterine contractions, and fetal distress. In some cases, there may be no visible bleeding, but the placenta has already started separating from the uterine wall, leading to internal hemorrhaging.
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Yes, there are two main types of Abruptio Placentae: 1) Complete abruption, where the placenta has fully separated from the uterine wall, and 2) Partial abruption, where only a portion of the placenta has detached. The severity of symptoms and risk to the mother and fetus can vary depending on the extent of the placental separation.
Early recognition and prompt management are critical for minimizing the risk of adverse outcomes in Abruptio Placentae. Quicky identifying the condition and providing appropriate medical interventions, such as controlling bleeding, monitoring fetal distress, and potentially delivering the baby, can greatly improve the chances of a positive outcome for both the mother and the infant.
PubCompare.ai can help researchers working on Abruptio Placentae in several ways. For example, the platform can assist in finding and comparing the latest protocols from literature, preprints, and patents to identify the most effective approaches for early diagnosis, risk assessment, and management of this serious obstetric condition. The AI-driven analysis can also help streamline the research process and boost productivity by highlighting key insights that might otherwise be missed.
More about "Abruptio Placentae"
Abruptio Placentae, also known as placental abruption, is a serious obstetric emergency characterized by the sudden, premature separation of the placenta from the uterine wall before the delivery of the fetus.
This condition can lead to severe bleeding, fetal distress, and potentially life-threatening complications for both the mother and the infant.
Early recognition and prompt management are critical to minimize the risk of adverse outcomes.
Healthcare professionals may utilize various tools and techniques to diagnose and manage Abruptio Placentae, such as SAS 9.4, SAS for Windows, and Stata software.
Additionally, laboratory tests like the NucleoSpin miRNA kit and the PureLink RNA Mini Kit may be employed to analyze biological samples.
Abruptio Placentae is a complex condition that requires a multidisciplinary approach.
Obstetricians, maternal-fetal medicine specialists, and neonatal intensive care teams often collaborate to provide the best possible care for patients.
Trypsin, a proteolytic enzyme, may be used in some medical procedures related to this condition.
In addition to the immediate medical concerns, Abruptio Placentae can have long-term implications for the mother and the infant.
Proper follow-up and rehabilitation, including the use of tools like SPSS 16.0 and Statistica 13.1, are essential to support the recovery process and monitor for any potential complications.
By staying informed about the latest advancements in the management of Abruptio Placentae, healthcare providers can optimize their research protocols and improve patient outcomes.
PubCompare.ai, a powerful AI-driven platform, can assist in this process by providing easy access to the most relevant literature, preprints, and patent information, enabling researchers to identify the best approaches and streamline their research effeorts.
