Abstract
Abruptio placentae fatal to the fetus or neonate was studied in a prospective series of 59,379 pregnancies with approximately 60,000,000 pieces of data used in the analyses. All diagnoses were made by a single pathologist. The fatal disorder had a frequency of 4.0/1000 live births. Necrosis of the decidua basalis at the placental margin, thrombosis of decidual arteries and large placental infarcts were the most characteristic placental abnormalities. The decidual necrosis was strongly correlated with gravidas' smoking and pregnancy weight gain. There was a parallel fetal growth retardation indicating that maternal under-nutrition may have contributed to the abruptions. An increased frequency of decidual necrosis at the placental margin was also found in successful, non-abruption pregnancies when the gravida smoked and when they had suboptimal pregnancy weight gains. An increased frequency of intrapartum but not prepartum maternal hypertension was observed in the fatal abruptio cases. Perinatal death was 42% more frequent in males than in females. The frequency of fatal abruptio was 86% greater when gravida made 0-2 clinic visits for prenatal care than when they made 5 or more such visits. This appeared related to weight gain, women who made more visits had higher weight gains at each gestational age than women who made fewer visits. (Supported by U.S.P.H.S. contract N01-NS-3-2311).
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Naeye, R., Hershey, M. ABRUPTIO PLACENTAE, A PROSPECTIVE STUDY. Pediatr Res 11, 438 (1977). https://doi.org/10.1203/00006450-197704000-00410
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DOI: https://doi.org/10.1203/00006450-197704000-00410