Maternal Outcomes of Placental Abruption With Intrauterine Fetal Death and Delivery Routes: A Nationwide Observational Study

Abstract

(Acta Obstet Gynecol Scand. 2023;102:708–715) Both maternal and neonatal morbidity and mortality are associated with placental abruption (PA), a condition where the placenta prematurely separates from the uterine wall before or during labor. PA and intrauterine fetal death (IUFD) can co-occur, making a delivery more complex as well as high risk, as shown through increased maternal morbidity rates. Worldwide, delivery for mothers with PA and IUFD varies between vaginal delivery (VD) and cesarean delivery (CD), although various sources cite VD as the preferred method. Frequent complications of VD for PA with IUFD includes a longer delivery time, uterine rupture, and substantial blood loss. CD is associated with hemorrhagic shock and hematoma formation due to a greater increase in blood loss. Limited, small-scale studies have been performed comparing VD and CD and the effect on maternal morbidity in cases with IUFD and PA; however, this study uses a large data set to understand the relationship between delivery method and morbidity in cases of PA with IUFD.