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Review
. 2011 Sep;38(3):407-21.
doi: 10.1016/j.clp.2011.06.001.

Abruption-associated prematurity

Christina S Han  1 , Frederick Schatz, Charles J Lockwood
Affiliations
Review

Abruption-associated prematurity

Christina S Han et al. Clin Perinatol. 2011 Sep.

Abstract

Chronic, subacute decidual hemorrhage (ie, abruptio placenta and retrochorionic hematoma formation) is an important contributor to preterm parturition. Such hemorrhage induces thrombin from decidual tissue factor, which plays a pivotal role in the development of preterm premature rupture of membranes and preterm delivery by acting through protease-activated receptors to promote the production of pro-inflammatory cytokines, and matrix-degrading metalloproteinases. Severe, acute abruption can lead to maternal and fetal mortality. Current management of abruption is individualized based on severity of disease, underlying etiology, and gestational age.

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Figures

Figure 1
Figure 1
Perinatal mortality in pregnancies with and without abruption across gestation, 2000–2002. Circles, pregnancies with abruption. Diamonds, pregnancies without abruption. (From Oyelese Y, Ananth CV. Placental abruption. Obstet Gynecol 2006;108(4):1005-16, with permission.)
Figure 2
Figure 2. Hemostatic, thrombotic, and fibrinolytic pathways
Ø, inhibitory effect; (+), stimulatory effect. (From Han CS, Paidas MJ, Lockwood CJ. Clotting Disorders. In: High Risk Pregnancy: Management Options. Eds: James DK, Steer PJ, Weiner CP et al. New York, NY: Saunders; 2010, with permission.)
Figure 3
Figure 3. Pathway to prematurity from Decidual Hemorrhage
FVIIa: activated factor VII; TF: tissue factor; PAR: protease-activated receptors; MMP: matrix metalloproteinases; ECM: extracellular matrix. (Courtesy of Charles J. Lockwood, MD, New Haven, Connecticut)
Figure 4
Figure 4
Rates of abruption across gestation, United States, 2000–2002 (From Oyelese Y, Ananth CV. Placental abruption. Obstet Gynecol 2006;108(4):1005-16, with permission.)
Figures 5 and 6
Figures 5 and 6
Retroplacental hematoma
Figure 7 and 8
Figure 7 and 8
Resolving hematoma with hypoechoic appearance
See this image and copyright information in PMC

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References

    1. Martin JA, Osterman MJ, Sutton PD. Are preterm births on the decline in the United States? Recent data from the National Vital Statistics System. NCHS Data Brief. 2010;39(39):1–8. - PubMed
    1. Behrman RE, Butler AS. Societal Costs of Prematurity. In: Behrman RE, Butler AS, editors. Preterm Birth: Causes, Consequences, and Prevention. Washington DC: National Academies Press; 2007. pp. 398–429. - PubMed
    1. Ananth CV, Berkowitz GS, Savitz DA, et al. Placental abruption and adverse perinatal outcomes. JAMA. 1999;282(17):1646–51. - PubMed
    1. Williams MA, Mittendorf R, Lieberman E, et al. Adverse infant outcomes associated with first-trimester vaginal bleeding. Obstet Gynecol. 1991;78(1):14–8. - PubMed
    1. Harger JH, Hsing AW, Tuomala RE, et al. Risk factors for preterm premature rupture of fetal membranes: a multicenter case-control study. Am J Obstet Gynecol. 1990;163(1 Pt 1):130–7. - PubMed