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Outcomes of Placental Abruption Depending on Severity of Pre-Eclampsia: A Multicentre Cohort Observational Retrospective Study

https://doi.org/10.23946/2500-0764-2024-9-2-37-54

Abstract

Aim. Placental abruption is a severe complication of pregnancy, which is often accompanied by pre-eclampsia and early delivery. Here we aimed to study maternal and neonatal outcomes in patients with placental abruption depending on the severity of pre-eclampsia.

Materials and Methods. The study included 509 patients with placental abruption and pre-eclampsia from 22 medical centers in 16 regions of the Russian Federation, which were divided into two groups: patients with placental abruption and severe pre-eclampsia (n = 369) and patients with placental abruption and moderate pre-eclampsia (n = 140).

Results. Regardless of the severity of pre-eclampsia, average term of placental abruption was 34 weeks of pregnancy. Among the adverse maternal outcomes in patients with placental abruption and severe pre-eclampsia were coagulopathy (OR = 5.01; 95% CI = 1.17–21.46) and near miss proportion (OR = 2.95; 95% CI =1.22 –7.08) which were significantly more common as compared to a moderate pre-eclampsia. Neonatal outcomes were accompanied by a high perinatal mortality (12.8%) and neonatal morbidity due to a high prevalence of premature birth (65%), asphyxia (64%), and small for gestational age (40%). Groups with severe and moderate pre-eclampsia had no statistically significant differences in neonatal outcomes, excepting congenital malformations which were found less frequently (OR = 0.32; 95% CI 0.13–0.79) in severe pre-eclampsia.

Conclusion. Severity of pre-eclampsia did not affect neonatal outcomes in women with placental abruption. Maternal outcomes were significantly worse in patients with severe pre-eclampsia in comparison with those with moderate pre-eclampsia.

About the Authors

I. S. Rudakova
Gutkin Republican Perinatal Center; Petrozavodsk State University
Russian Federation

Dr. Irina S. Rudakova, MD, Head of the Department of Obstetric Pathology

9, Syktyvkarskaya Street, Petrozavodsk 185002, Republic of Karelia


E. M. Shifman
Vladimirsky Moscow Regional Research Clinical Institute; Pirogov Russian National Research Medical University
Russian Federation

Prof. Efim M. Shifman, MD, DSc, Professor, Head of the Department of Anesthesiology and Critical Care

61/2, Shchepkina Street, Moscow, 129110 


G. P. Tikhova
Petrozavodsk State University
Russian Federation

Dr. Galina P. Tikhova, MD, Researcher, Institute of High Medical Technologies

33, Lenina Prospekt, Petrozavodsk, 185910 


M. A. Andriyakhova
Altai Regional Clinical Perinatal Center
Russian Federation

Dr. Margarita A. Andriyakhova, MD, Head of the Labor and Delivery Unit 

154, Fomina Street, Barnaul, Altai Region, 656047 


N. V. Artymuk
Kemerovo State Medical University
Russian Federation

Prof. Natalia V. Artymuk, MD, DSc, Professor, Head of the Ushakova Department of Obstetrics and Gynecology

22a, Voroshilova Street, Kemerovo, 650056 


V. A. Bagiyants
Sverdlovsk Regional Children Clinical Hospital
Russian Federation

Dr. Vladimir A. Bagiyants, MD, Obstetrician-Gynecologist, Sverdlovsk Perinatal Centre

32, Serafima Deryabina Street, Ekaterinburg 


F. R. Barakaeva
Ott Research Institute of Obstetrics, Gynecology and Reproductology
Russian Federation

Dr. Feride R. Barakaeva, MD, Anesthesiologist and Critical Care Specialist 

3, Mendeleyevskaya Line, Saint Petersburg, 199034 


S. V. Barinov
Omsk State Medical University
Russian Federation

Prof. Sergey V. Barinov, MD, DSc, Professor, Head of the Department of Obstetrics and Gynecology #2

12, Lenina Street, Omsk, 644099 


N. A. Barkovskaya
Dzerzhinsk Perinatal Center; Privolzhsky Research Medical University
Russian Federation

Dr. Natalia A. Barkovskaya, MD, PhD, Head of the Department of Anesthesiology and Critical Care Medicine; Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Additional Professional Education

89, Tsiolkovskogo Street, Dzerzhinsk, Nizhny Novgorod Region, 606033 

10/1, Minin and Pozharsky Square, Nizhny Novgorod, 603950 


A. A. Belinina
Altai Regional Clinical Perinatal Center
Russian Federation

Dr. Antonina A. Belinina, MD, PhD, Deputy Chief Physician 

154, Fomina Street, Barnaul, 656047 


T. E. Belokrinitskaya
Chita State Medical Academy
Russian Federation

Prof. Tatiana E. Belokrinitskaya, MD, DSc, Professor, Head of the Obstetrics and Gynecology Department, Pediatric Faculty and Faculty of Professional Retraining

39a, Gorkogo Street, Chita, 672000 


R. V. Bikkuzhin
Petrozavodsk State University
Russian Federation

Dr. Rostislav V. Bikkuzhin, MD, Resident, Department of Obstetrics, Gynecology and Perinatology

33, Lenina Prospekt, Petrozavodsk, 185910 


A. V. Bulavintseva
Simferopol Clinical Hospital
Russian Federation

Dr. Anastasia V. Bulavintseva, Assistant Professor, Department of General Surgery, Anaesthesiology and Critical Care Medicine, Georgievsky Medical Academy

4, Academician Vernadsky Avenue, Simferopol, Republic of Crimea, 295007 


E. A. Bukharova
Omsk State Medical University
Russian Federation

Dr. Elena A. Bukharova, MD, PhD, Associate Professor, Department of Obstetrics and Gynecology #1 

12, Lenina Street, Omsk, 644099 


A. A. Bukhtin
Volgograd Regional Clinical Perinatal Center
Russian Federation

Dr. Alexander A. Bukhtin, MD, PhD, Anesthesiologist and Critical Care Specialist, Chief Physician

12a, Pushkina Street, Volgograd Region, Volzhsky, 404130 


I. G. Verveiko
Postol Perinatal Center
Russian Federation

Dr. Irina G. Verveiko, MD, Head of the Department of Anesthesiology and Critical Care Medicine

85, Istomina Street, Khabarovsk, 680028, 


V. S. Gorokhovskiy
Far Eastern State Medical University
Russian Federation

Prof. Vadim S. Gorokhovskiy, MD, PhD, Associate Professor, Head of the Department of Anesthesiology and Resuscitation, Transfusion Medicine and Emergency Medicine

 35, MuravyovaAmurskogo Strееt, Khabarovsk, 680000 


D. E. Gurbanov
Razumovsky Saratov State Medical University
Russian Federation

Dr. Dovlet E. Gurbanov, MD, Anesthesiologist and Critical Care Specialist, Department of Anesthesiology and Critical Care Medicine

33, Building 1, Zernovaya Street, Saratov, Saratov Region, 410047 


E. N. Degtyarev
Mukhin City Clinical Hospital
Russian Federation

Dr. Evgeny N. Degtyarev, MD, PhD, Head of the Department 

17, Federativnyi Prospekt, Moscow, 111399 


K. G. Eliseeva
Razumovsky Saratov State Medical University; Saratov Clinical Perinatal Center
Russian Federation

Dr. Karina G. Eliseeva, MD, Deputy Chief Physician of Obstetrics and Gynecology 

33, Building 1, Zernovaya Street, Saratov, Saratov Region, 410047 


A. A. Ivshin
Petrozavodsk State University
Russian Federation

Dr. Alexander A. Ivshin, MD, PhD, Associate Professor, Head of the Department of Obstetrics, Gynecology and Perinatology

33, Lenin Avenue, Petrozavodsk,185910 


R. V. Kapustin
Ott Research Institute of Obstetrics, Gynecology and Reproductology
Russian Federation

Prof. Roman V. Kapustin, MD, DSc, Head of the Department of Obstetrics and Perinatology

3, Mendeleyevskaya Line, Saint Petersburg, 199034 


N. Yu. Katkova
Privolzhsky Research Medical University
Russian Federation

Prof. Nadezhda Yu. Katkova, MD, DSc, Professor, Head of the Department of Obstetrics and Gynecology, Faculty of Additional Professional Education

10/1, Minin and Pozharsky Square, Nizhny Novgorod, 603950 


K. A. Kargina
Chita State Medical Academy
Russian Federation

Dr. Kristina A. Kargina, MD, Assistant Professor, Obstetrics and Gynecology Department, Pediatric Faculty and Faculty of Professional Retraining

39a, Gorkogo Street, Chita, 672000 


P. V. Kokh
Krasnoyarsk Regional Clinical Center for Maternity and Childhood Protection
Russian Federation

Dr. Polina V. Kokh, MD, Anesthesiologist and Critical Care Specialist 

2A, Akademika Kirenskogo Street, Krasnoyarsk, 660074 


A. A. Kuverin
Perinatal Center of the Saratov City Clinical Hospital #8
Russian Federation

Dr. Alexeу A. Kuverin, MD, Anesthesiologist and Critical Care Specialist 

2, Building 46a, Odesskaya Street, Saratov, Saratov region, 410052 


L. V. Kuklina
Omsk State Medical University
Russian Federation

Dr. Larisa V. Kuklina, MD, PhD, Associate Professor, Department of Obstetrics and Gynecology #1

12, Lenina Street, Omsk, 644099 


A. V. Kulikov
Ural State Medical University
Russian Federation

Prof. Alexander V. Kulikov, MD, DSc, Head of the Department Anesthesiology and Critical Care Medicine, Toxicology

3, Repina Street, Yekaterinburg, Sverdlovsk region, 620028 


T. Yu. Marochko
Kemerovo State Medical University
Russian Federation

Dr. Tatiana Yu. Marochko, MD, PhD, Associate Professor, Ushakova Department of Obstetrics and Gynecology 

22a, Voroshilova street, Kemerovo, 650056 


D. V. Marshalov
Razumovsky Saratov State Medical University
Russian Federation

Dr. Dmitry V. Marshalov, MD, DSc, Associate Professor 

112, Bolshaya Kazachya Street, 410012, Saratov 


N. M. Milyaeva
Ural State Medical University
Russian Federation

Dr. Natalia M. Milyaeva, MD, DSc, Associate Professor, Department of Obstetrics, Gynecology and Medical Genetic

3, Repina Street, Ekaterinburg, Sverdlovsk region, 620028 


A. A. Golovachuk
Georgievsky Medical Academy, Vernadsky Crimean Federal University
Russian Federation

Dr. Anastasia A. Golovachuk, MD, Resident, Department of General Surgery, Anaesthesiology, Critical Care and Emergency Medicine, Georgievsky Medical Academy

4, Academician Vernadsky Prospekt, Simferopol, Republic of Crimea, 295007 


E. S. Nadezhina
Omsk Regional Perinatal Center
Russian Federation

Dr. Evgenia S. Nadezhina, MD, Obstetrician-Gynecologist, Department of Obstetric Physiology

3, Berezovaya Street, Omsk, 644111 


S. V. Novikova
Moscow Regional Research Institute of Obstetrics and Gynecology
Russian Federation

Prof. Svetlana V. Novikova, MD, DSc, Professor, Head of the Obstetric Observational Department

22a, Pokrovka Street, Moscow,101000 


S. V. Ovechkin
Novosibirsk City Clinical Perinatal Center
Russian Federation

Dr. Sergey V. Ovechkin, MD, PhD, Head of the Department of Anesthesiology and Critical Care Medicine

32, Andrien Lezhena Street, Novosibirsk, 630089 


A. V. Petrov
Maikop City Clinical Hospital; Adyghea Republican Clinical Perinatal Center
Russian Federation

Dr. Alexeу V. Petrov, MD, Anesthesiologist and Critical Care Specialist, Resident

4, Gagarina Street, Maykop, Republic of Adyghea, 385000 


I. M. Pozdnyakov
Novosibirsk City Clinical Perinatal Center
Russian Federation

Prof. Ivan M. Pozdnyakov, MD, DSc, Professor, Chief Physician 

32, Andrien Lezhena street, Novosibirsk, 630089 


E. G. Prodanchuk
Omsk State Medical University
Russian Federation

Dr. Evgeny G. Prodanchuk, MD, PhD, Associate Professor, Department of Obstetrics and Gynecology #1

12, Lenina Street, 644099, Omsk 


N. Yu. Pylaeva
Georgievsky Medical Academy, Vernadsky Crimean Federal University
Russian Federation

Dr. Natalia Yu. Pylaeva, MD, PhD, Associate Professor, Department of General Surgery, Anaesthesiology, Critical Care and Emergency Medicine, Georgievsky Medical Academy

4, Academician Vernadsky Prospekt, Simferopol, Republic of Crimea, 295007 


O. V. Riazanova
Ott Research Institute of Obstetrics, Gynecology and Reproductology
Russian Federation

Prof. Oksana V. Riazanova, MD, DSc, Head of the Department of Anesthesiology and Critical Care Medicine, Leading Researcher, Department of Obstetrics and Perinatology

3, Mendeleyevskaya Line, Saint Petersburg, 199034 


I. V. Savelyeva
Omsk State Medical University
Russian Federation

Prof. Irina V. Savelyeva, MD, DSc, Associate Professor, Head of the Department of Obstetrics and Gynecology #1

12, Lenina Street, 644099, Omsk 


A. A. Sleta
Volgograd Regional Clinical Perinatal Center
Russian Federation

 Dr. Anna A. Sleta, MD, Obstetrician-Gynecologist 

12a, Pushkina Street, Volgograd Region, Volzhsky city, 404130 


V. D. Snezhko
Vishnevsky National Medical Research Center of Surgery
Russian Federation

Dr. Vera D. Snezhko, MD, Clinical Resident 

27, Bolshaya Serpukhovskaya Street, Moscow, 115093 


M. G. Tupikin
Krasnoyarsk Regional Clinical Center for Maternity and Childhood Protection
Russian Federation

Dr. Mikhail G. Tupikin, MD, Anesthesiologist and Critical Care Specialist 

2A, Akademika Kirenskogo Street, Krasnoyarsk, 660074 


E. Yu. Upryamova
Moscow Regional Research Institute of Obstetrics and Gynecology
Russian Federation

Dr. Ekaterina Yu. Upryamova, MD, PhD, Head of the Department of Anesthesiology and Critical Care Medicine

22a, Pokrovka street, Moscow,101000 


A. I. Cherny
Razumovsky Saratov State Medical University; Perinatal Center of the Saratov City Clinical Hospital #8
Russian Federation

Dr. Alexey I. Cherny, MD, PhD, Head of the Department of Anesthesiology and Critical Care Medicine #1, Perinatal Center 

44A, Odesskaya Street, Saratov, 410052 


N. V. Shindyapina
Razumovsky Saratov State Medical University; Saratov Clinical Perinatal Center
Russian Federation

Dr. Natalia V. Shindyapina, MD, Assistant Professor, Department of Emergency Anesthesiology, Resuscitation and Simulation Technologies in Medicine

112, Bolshaya Kazachya Street, Saratov, 410012 


O. B. Shulman
Maikop City Clinical Hospital; Adyghea Republican Clinical Perinatal Center
Russian Federation

Dr. Oleg B. Shulman, MD, Head of the Department of Anesthesiology and Critical Care Medicine

4, Gagarina Street, Maykop, Republic of Adygea, 385000 


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For citations:

Rudakova I.S., Shifman E.M., Tikhova G.P., Andriyakhova M.A., Artymuk N.V., Bagiyants V.A., Barakaeva F.R., Barinov S.V., Barkovskaya N.A., Belinina A.A., Belokrinitskaya T.E., Bikkuzhin R.V., Bulavintseva A.V., Bukharova E.A., Bukhtin A.A., Verveiko I.G., Gorokhovskiy V.S., Gurbanov D.E., Degtyarev E.N., Eliseeva K.G., Ivshin A.A., Kapustin R.V., Katkova N.Yu., Kargina K.A., Kokh P.V., Kuverin A.A., Kuklina L.V., Kulikov A.V., Marochko T.Yu., Marshalov D.V., Milyaeva N.M., Golovachuk A.A., Nadezhina E.S., Novikova S.V., Ovechkin S.V., Petrov A.V., Pozdnyakov I.M., Prodanchuk E.G., Pylaeva N.Yu., Riazanova O.V., Savelyeva I.V., Sleta A.A., Snezhko V.D., Tupikin M.G., Upryamova E.Yu., Cherny A.I., Shindyapina N.V., Shulman O.B. Outcomes of Placental Abruption Depending on Severity of Pre-Eclampsia: A Multicentre Cohort Observational Retrospective Study. Fundamental and Clinical Medicine. 2024;9(2):37-54. (In Russ.) https://doi.org/10.23946/2500-0764-2024-9-2-37-54

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