Poster Session 3
Category: Clinical Obstetrics
Poster Session 3
Nirit Maliyanker, MD
Sheba Medical Center
Ramat Gan, HaMerkaz, Israel
Michal Fishel Bartal, MD
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Guy Dumanis
Education Authority, Chaim Sheba Medical Center
Sheba Medical Center, HaMerkaz, Israel
Noa Gonen, MD
MFM Fellow
Wolfson Medical Center
Holon, HaMerkaz, Israel
.jpg "Avishag Abecassis, MD, MSc photo")
Avishag Abecassis, MD, MSc
MFM Fellow
Department of Obstetrics and Gynecology, Sheba Medical Center
Ramat Gan, HaMerkaz, Israel
Lital Shaham, MD, PhD (she/her/hers)
Resident Physician, Department of Obstetrics and Gynecology, Sheba Medical Center
Department of Obstetrics and Gynecology, Sheba Medical Center
Sheba Medical Center, HaMerkaz, Israel
To evaluate maternal morbidity in individuals with placental abruption, comparing outcomes between those delivering preterm (< 37 weeks) and at term (≥37 weeks).
Study Design:
We conducted a retrospective cohort study of individuals presenting with placental abruption at a tertiary medical center between 2011 and 2025. We excluded those with placenta previa, placenta accreta spectrum, or multifetal gestation. The primary outcome was a composite of severe maternal adverse outcomes including any of the following maternal death, disseminated intravascular coagulation (DIC), intensive care unit (ICU) admission, postpartum hemorrhage, blood transfusion, re-laparotomy or re-admission.
Results:
Of 144,601 deliveries during the study period 1,360 (1%) presented with placental abruption, of them 450 (33.1%) delivered preterm. The preterm group had lower BMI )25.95 vs 27.1 p< 0.001), and nulliparity (33.8% vs 42.6%, p=0.002), higher rate of chronic hypertension (2.9% vs. 1.2%, p=0.05), thrombophilia (6% vs. 3%, p=0.011), antiphospholipid syndrome (3.1% vs. 1.2%, p=0.025), past preterm delivery (2.7 vs 0.8, p=0.01), preeclampsia (8% vs. 3%, p< 0.001), severe preeclampsia (2.2% vs. 0.2%, p< 0.001), premature contraction (18% vs.11% p< 0.001) and blood products administration during pregnancy (8.2% vs. 0.7% p< 0.001) compared to term abruption. The rate of composite severe maternal morbidity was higher in the preterm group compared to term abruption (10.7 vs 5.4%, p=0.001). Significant differences were found in various components of the composite outcome such as higher rate of ICU admission (1.1% vs. 0.1% p=0.017), higher rate of DIC (2.4% vs.0.2% p< 0.001), re-laparotomy (2.9% vs.0.9%, p=0.009) and re-admission (2.2% vs. 0.1% p< 0.001).
Conclusion:
The composite outcome was significantly more prevalent in the preterm delivery group compared to term deliveries. Various component of the composite outcome was also observed at higher rates among the preterm group. These findings underscore the importance of strategic planning and preparedness in managing preterm deliveries associated with placental abruption.