Prediction of fetal acidemia in placental abruption
1 Department of Obstetrics and Gynecology, Tokyo Women’s Medical University, Kawada-cho, 8-1, Shinjuku-ku, Tokyo 162-8666, Japan
2 Perinatal Medical Center, Tokyo Women’s Medical University, Kawada-cho, 8-1, Shinjuku-ku, Tokyo 162-8666, Japan
3 Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara-City, Tochigi-Prefecture 329-2763, Japan
BMC Pregnancy and Childbirth 2013, 13:156 doi:10.1186/1471-2393-13-156Published: 1 August 2013
To determine the major predictive factors for fetal acidemia in placental abruption.
A retrospective review of pregnancies with placental abruption was performed using a logistic regression model. Fetal acidemia was defined as a pH of less than 7.0 in umbilical artery. The severe abruption score, which was derived from a linear discriminant function, was calculated to determine the probability of fetal acidemia.
Fetal acidemia was seen in 43 survivors (43/222, 19%). A logistic regression model showed bradycardia (OR (odds ratio) 50.34, 95% CI 11.07 – 228.93), and late decelerations (OR 15.13, 3.05 – 74.97), but not abnormal ultrasonographic findings were to be associated with the occurrence of fetal acidemia. The severe abruption score was calculated for the occurrence of fetal acidemia, using 6 items including vaginal bleeding, gestational age, abdominal pain, abnormal ultrasonographic finding, late decelerations, and bradycardia.
An abnormal FHR pattern, especially bradycardia is the most significant risk factor in placental abruption predicting fetal acidemia, regardless of the presence of abnormal ultrasonographic findings or gestational age.