Evidence of placental abruption as a chronic process: associations with vaginal bleeding early in pregnancy and placental lesions

European Journal of Obstetrics, Gynecology, and Reproductive Biology
Cande V AnanthJohn C Smulian

Abstract

Clinicians widely regard placental abruption as an acute event, though accumulating data point towards abruption being the end-result of chronic processes early in pregnancy, and perhaps even extending to conception. The Collaborative Perinatal Project was a prospective cohort study performed from 1959 to 1966 in the United States. Since enrolled pregnancies were managed without the biases created by modern perinatal surveillance and interventions, the natural history of disease in these data is ideal to study obstetrical complications such as placental abruption. We assessed the associations versus contributions of the clinical feature of early gestational vaginal bleeding and histologic lesions (chronic and acute) with placental abruption. Women enrolled in the Collaborative Perinatal Project (1959-1966) were used, restricting the analysis to those that delivered singleton births (n=46,364). Risks of placental abruption were compared between women with and without vaginal bleeding at <20 weeks gestation. We also examined the relationships between placental abruption and chronic and acute histologic lesions, including infarcts, decidual necrosis, presence of macrophages in the decidua, amnion or chorion, and neutrophil infiltr...Continue Reading

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Citations

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