ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT CỤC THAI KỲ CÁC TRƯỜNG HỢP NHAU BONG NON TẠI BỆNH VIỆN HÙNG VƯƠNG

Abstract

Background: Placental abruption is an obstetric emergency with a relatively low incidence (0.6–1%), but it is associated with high fetal and maternal mortality if not managed promptly. Studying the clinical and paraclinical characteristics of different types of placental abruption may help identify factors that predict disease severity, thereby reducing related complications. Objective: To investigate the clinical features, paraclinical findings, and pregnancy outcomes of different types of placental abruption diagnosed intraoperatively at Hung Vuong Hospital. Methods: This was a retrospective case series including all pregnant women diagnosed with placental abruption after surgery at Hung Vuong Hospital over a 5-year period, from January 2017 to December 2021. Results: Among 290 cases, common clinical features included abdominal pain (84.5%), vaginal bleeding (55.9%), severe preeclampsia (64.9%), and ultrasound-detected retroplacental hematoma (30.7%). Maternal outcomes included severe and extensive uterine muscle damage (1.8%), mean blood loss of 458.3 ± 237.56 mL, coagulopathy in 3.5% of cases, and a mean hospital stay of 4.5 ± 1.78 days. Neonatal outcomes showed a mean birth weight of 2311 ± 779 grams, a live birth rate of 86.2%, and neonatal intensive care unit admission in 32.7% of cases. Factors associated with severe placental abruption included maternal age ≥ 35 years (OR = 0.27; 95% CI: 0.10–0.72; p = 0.01), preeclampsia (OR = 2.30; 95% CI: 1.05–5.03; p = 0.04), and a time interval ≥ 20 minutes from diagnosis to surgery (OR = 2.32; 95% CI: 1.13–4.77; p = 0.02). Conclusions: Placental abruption is a critical obstetric emergency that requires timely diagnosis and intervention to reduce adverse maternal and neonatal outcomes.