| Abstract | Cilj: Cilj je ovog retrospektivnog istraživanja bio ispitati incidenciju trudnoća s dijagnozom abrupcije posteljice i placente previje, rizične čimbenike za njihov nastanak, način dovršenja takvih trudnoća i perinatalni ishod. Metode: U istraživanju su korišteni arhivski podaci Klinike za ženske bolesti i porode KBC-a Zagreb u razdoblju od 01.01.2013. – 31.12.2013. godine. Rezultati: Od ukupno 4338 porođaja (> 22 tjedna trudnoće), 28 (0,65%) trudnica imalo je dijagnozu abrupcije placente, a 14 (0,32%) trudnica dijagnozu placente previje. Nije nađena značajna razlika u načinu dovršenja trudnoće s obzirom na dijagnozu (p = 0.824). Kod trudnica s placentom previjom, 2 od 14 (14,26 %)
trudnoca dovršena je vaginalnim putem. Tri (10,71 %) trudnice s abrupcijom posteljice rodilo je vaginalno, a kod 25 (89,29%) trudnica učinjen je carski rez. Hipertenziju u trudnoći imalo je 5 (17,86%) trudnica s dijagnozom abrupcije posteljice. Vaginalno krvarenje bilo je prisutno u 12 (42,86 %) trudnica s dijagnozom abrupcije placente, a 8 (57,14%) kod placente previje. Placentu previju imalo je 12 (85,71%) višerodilja. U skupini s placentom previjom 8 (57,14 %) trudnica bilo je starije od 35 godina, a kod 5 (35,71 %) trudnica su prethodne trudnoće dovršene carskim rezom. Sedam (25%) trudnoća s abrupcijom posteljice je dovršeno prije 32. tjedna gestacije, dok je 8 (57,14%) trudnoća s placentom previjom dovršeno nakon 37. tjedna gestacije. Perinatalni ishod kod abrupcije placente bio je lošiji zbog češćeg prijevremenog rađanja. pH vrijednost iz pupkovine statistički je značajno niža u skupini s abrupcijom posteljice u odnosu na pH vrijednost u skupini s placentom previjom (p = 0.012). Kod 1 (7,14%) trudnice s placentom previjom pH pupčane vene bio je niži od 7.20, dok je kod abrupcije posteljice 15 (53,57%) imalo pH jednak ili niži od 7,20.
Zaključak: Učestalost abrupcije posteljice (0,65%) značajno je češća od placente previje (0,32%). U obje skupine trudnoće se najčešće dovršavaju carskim rezom. Uzevši u obzir rizične čimbenike i kliničku sliku, perinatalni ishod u prosjeku je bolji u trudnoćama s dijagnozom placente previje u usporedbi s trudnoćama s abrupcijom posteljice. |
| Abstract (english) | Aim: This retrospective study was conducted to determine the incidence of placental abruption and placenta previa in pregnancy, risk factors, mode of delivery in these cases and perinatal outcomes.
Methods: The data were collected from the archive of Department of Obstetrics and Gynecology, University Hospital Center Zagreb during the period from 1st January 2013 until 31st December 2013.
Results: Among 4338 deliveries (> 22 weeks of gestation) 28 (0,65%) pregnancies were complicated with placental abruption and 14 (0,32%) were complicated with placenta previa. We observed no significant difference in the mode of delivery according to diagnosis (p = 0,824). In the group with placenta previa 2 (14,26%) had vaginal delivery, whereas 3 (10,71%) pregnancies with placental abruption had vaginal delivery and 25 (89,29%) had cesarean section. Five (17,86%) pregnancies with placental abruption were complicated with hypertension in pregnancy. Vaginal bleeding was present in 12 (42,86%) pregnancies diagnosed with placental abruption and 8 (57,14%) in placenta previa group. There were 12 (85,71%) multipara in the group with placenta previa. Eight (57,14%) patients in this group were older than 35, and 5 (35,71%) had a previous delivery by Cesarean section. Seven (25%) pregnancies with placental abruption were terminated before 32 weeks, and 8 (57,14%) pregnancies in the placenta previa group after 37 weeks. In relation to the perinatal outcome in pregnancies with placental abruption was worse than in placenta previa group, because of frequent premature birth. We observed significantly lower umbilical vein pH in the group with placental abruption compared to the group with placenta previa (p = 0,012). Only one case (7,14%) of the placenta previa group had umbilical vein pH 7.20, whereas 15 (53,57%) in the group with placental abruption had pH 7.20.
Conclusion: Incidence of placental abruption is significantly more frequent than placenta previa. In both groups pregnancies are mostly terminated by caesarean section. Taking into consideration risk factors and clinical symptoms, perinatal outcome is better in pregnancies with placenta previa compared to pregnancies with placental abruption. |
