Placental abruption (PA) is a major obstetric complication associated with worse maternal and neonatal outcomes. Though ultrasound findings may support the diagnosis of PA, the association of such findings to the severity of PA and maternal and neonatal outcomes is not yet clear. We aimed to assess the maternal and neonatal outcomes of PA cases with vs. without related sonographic findings. In this retrospective cohort study, all deliveries complicated by PA between 2009 and 2022 were included. Placental histopathology, obstetric, and neonatal outcomes were compared between cases of PA with vs. without supporting sonographic findings. A composite of severe neonatal morbidity was compared between the groups, including ≥1 of the following: seizures, intraventricular hemorrhage, hypoxic-ischemic encephalopathy, periventricular leukomalacia, respiratory-distress syndrome, sepsis, anemia, blood transfusion or death. Of the 420 cases with PA eligible for the study, 50 patients (12 %) were in the PA with sonographic features group and 370 (88 %) were in the PA without sonographic features group. The PA with sonographic features group was characterized by significantly higher rates of prematurity (p < 0.001), severe composite adverse neonatal outcome (p < 0.01), and a composite maternal vascular malperfusion lesions in placental histopathology (p = 0.001) PA with supporting sonographic features is associated with higher rates of adverse obstetric and neonatal outcomes and placental lesions. These findings emphasize the importance of sonographic evaluation for every case of PA before deciding upon management.

中文翻译：

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妊娠并发胎盘早剥的产科和新生儿结局，有与无支持超声检查结果——一项回顾性队列研究


胎盘早剥（PA）是一种主要的产科并发症，与较差的孕产妇和新生儿结局相关。尽管超声检查结果可能支持 PA 的诊断，但此类检查结果与 PA 严重程度以及孕产妇和新生儿结局之间的关联尚不清楚。我们的目的是评估有或没有相关超声检查结果的 PA 病例的孕产妇和新生儿结局。在这项回顾性队列研究中，纳入了 2009 年至 2022 年期间所有并发 PA 的分娩。对有和无支持超声检查结果的 PA 病例的胎盘组织病理学、产科和新生儿结局进行比较。比较各组之间的严重新生儿发病率，包括≥1种以下情况：癫痫、脑室内出血、缺氧缺血性脑病、脑室周围白质软化、呼吸窘迫综合征、败血症、贫血、输血或死亡。在符合本研究资格的 420 例 PA 病例中，50 例患者 (12%) 属于有超声检查特征的 PA 组，370 例 (88%) 属于无超声检查特征的 PA 组。具有超声检查特征的 PA 组的特点是早产率显着较高 (p < 0.001)、严重的复合不良新生儿结局 (p < 0.01) 以及胎盘组织病理学中复合母体血管灌注不良病变 (p = 0.001)支持超声检查特征与较高的不良产科和新生儿结局以及胎盘病变发生率相关。这些发现强调了在决定治疗之前对每个 PA 病例进行超声检查评估的重要性。