Obstetrics and Gynecology

doi: 10.25005/2074-0581-2023-25-4-527-540
PREMATURE SEPARATION OF THE NORMALLY IMPLANTED PLACENTA

Z.D. SALIMOVA, M.F. DODKHOEVA, D.A. SAYDALIEVA

Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Methods: This paper provides a literature review on premature separation of the normally implanted placenta (PSNIP), also known as placental abruption or abruptio placentae, a severe pregnancy and childbirth complication. Acute placental abruption is an obstetric complication that causes massive internal bleeding, leading to intrauterine fetal death. The bleeding can also contribute to multiple organ failure, which is responsible for the high rates of maternal and perinatal morbidity and mortality associated with this obstetric complication. Researching various aspects of complications and preventing the occurrence of PSNIP is of great medical and social significance. PubMed and Google Scholar electronic databases were used to analyze placental abruption studies, resulting in over 3,000 sources. After considering keywords, 60 sources were selected and included in the study.

Keywords: Placenta, premature separation of the normally implanted placenta, risk factors, pregnancy, preeclampsia, maternal mortality, DIC, Couvelaire uterus.

Download file:


References
  1. Schmidt P, Skelly CL, Raines DA. Placental Abruption. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. PMID: 29493960.
  2. Bączkowska M, Zgliczyńska M, Faryna J, Przytuła E, Nowakowski B, Ciebiera M. Molecular changes on maternal-fetal interface in placental abruption – a systematic review. Int J Mol Sci. 2021;22(12):6612. https://doi.org/10.3390/ ijms22126612
  3. Mikuscheva A, Strassding F, MacKenzie E. Three cases of severe placental abruption as a first symptom of preeclampsia. Case Rep Obstet Gynecol. 2021;2021:3863607. https://doi.org/10.1155/2021/3863607
  4. Brăila AD, Gluhovschi A, Neacşu A, Lungulescu CV, Brăila M, Vîrcan EL, et al. Placental abruption: Etiopathogenic aspects, diagnostic and therapeutic implications. Rom J Morphol Embryol. 2018;59(1):187-95.
  5. Li Y, Tian Y, Liu N, Chen Y, Wu F. Analysis of 62 placental abruption cases: Risk factors and clinical outcomes. Taiwan J Obstet Gynecol. 2019;58(2):223-6. https://doi.org/10.1016/j.tjog.2019.01.010
  6. Eubanks AA, Walz S, Thiel LM. Maternal risk factors and neonatal outcomes in placental abruption among patients with equal access to health care. J Matern Fetal Neonatal Med. 2021;34(13):2101-6. https://doi.org/10.1080/14767058. 2019.1657088
  7. Ananth CV, Kioumourtzoglou MA, Huang Y, Ross Z, Friedman AM, Williams MA, et al. Exposures to air pollution and risk of acute-onset placental abruption: A case-crossover study. Epidemiology. 2018;29(5):631-8. https://doi. org/10.1097/EDE.0000000000000859
  8. Omurbekova MM, Kangeldieva AA, Musuraliev MS. Vozmozhnosti organosokhraneniya pri tyazhyoloy otsloyke platsenty s koagulopaticheskim krovotecheniem [Possibilities of organ preservation in severe placental abruption with coagulopathic bleeding]. Meditsina. 2018;6(4):39-47.
  9. Nechaeva YuS, Kurako IA, Firsova AG. Prezhdevremennaya otsloyka normal'no raspolozhennoy platsenty. Analiz klinicheskikh sluchaev [Premature detachment of a normally located placenta. Analysis of clinical cases]. Estestvennye i tekhnicheskie nauki. 2019;3:176-9.
  10. Moshkalova G, Asankhan N, Tursynbaeva Sh, Dukembaeva A, Sharipov M. Perinatal'nye iskhody i prichiny prezhdevremennoy otsloyki normal'no raspolozhennoy platsenty [Perinatal outcomes and causes of premature deportment of a normally located placenta]. Aktual'nye nauchnye issledovaniya v sovremennom mire. 2018;10:28-31.
  11. Qiu Y, Wu L, Xiao Y, Zhang X. Clinical analysis and classification of placental abruption. J Matern Fetal Neonatal Med. 2021;34(18):2952-6. https://doi.org/ 10.1080/14767058.2019.1675625
  12. Urtenova LR. Dorodovoe krovotechenie [Prenatal bleeding]. Moya professional'naya kar'era. 2020;1:143-6.
  13. Tumanova UN, Shuvalova MP, Shchyogolev AI. Otsloyka platsenty i rannyaya neonatal'naya smertnost' (po dannym Rosstata v 2012-2016 godakh) [Placental department and early neonatal mortality (according to Rosstat in 2012- 2016)]. Mezhdunarodnyy zhurnal prikladnykh i fundamental'nykh issledovaniy. 2018;4:86-90.
  14. Babadzhanova GS, Razzakberganova GO, Sattarova KA. Faktory riska razvitiya prezhdevremennoy otsloyki normal'no raspolozhennoy platsenty [Risk factors for the development of premature detachment of a normally located placenta]. Biologiya i integrativnaya meditsina. 2017;11:14-9.
  15. Pariente G, Wainstock T, Walfisch A, Landau D, Sheiner E. Placental abruption and long‐term neurological hospitalisations in the offspring. Paediatric and Perinatal Epidemiology. 2019;33(3):215-22. https://doi.org/10.1111/ ppe.12553
  16. Niyazmetov RE, Matyakubov BB, Khabibullaev DM. Osobennosti lecheniya massivnogo akusherskogo krovotecheniya v retrospektivnoy gruppe [Features of the treatment of massive obstetric bleeding in the retrospective group]. Meditsina neotlozhnykh sostoyaniy. 2020;16(4):70-4.
  17. Rasmussen S, Ebbing C, Linde LE, Baghestan E. Placental abruption in parents who were born small: Registry-based cohort study. BJOG. 2018;125(6):667-74. https://doi.org/10.1111/1471-0528.14837
  18. Khazaei S, Jenabi E, Veisani Y. The association of Mullerian anomalies and placenta abruption: A meta-analysis. J Matern Fetal Neonatal Med. 2019;32(3):512-6. https://doi.org/10.1080/14767058.2017.1379072
  19. Rudakova IS, Shifman EM, Gumenyuk EG, Tikhova GP. Prezhdevremennaya otsloyka platsenty. Epidemiologiya, faktory riska. Sistematicheskiy obzor [Premature detachment of the placenta. Epidemiology, risk factors. Systematic review]. Voprosy ginekologii, akusherstva i perinatologii. 2021;20(3):118-33. https://doi.org/10.20953/1726-1678-2021-3-118-133
  20. Martinelli KG, Garcia ÉM, Santos Neto ETD, Gama SGND. Advanced maternal age and its association with placenta praevia and placental abruption: A meta-analysis. Cad Saude Publica. 2018;34(2):e00206116. https://doi. org/10.1590/0102- 311X0020611625
  21. Masoumi SZ, Kashanian M, Arab E, Sheikhansari N, Arab R. A comparison between pregnancy outcome in women in 15 to 19 and 20 to 35 years age group. Medical Journal of the Islamic Republic of Iran. 2017;31:140. https:// doi.org/10.14196/mjiri.31.14018
  22. Novikov EI, Osipov AV, Gorbakova LSh. Krovotecheniya v akushersko-ginekologicheskoy praktike [Bleeding in obstetric and gynecological practice]. Global Reproduction. 2021;2:76-81.
  23. Shchyogolev AI, Tumanova UN, Mishnev OD. Vliyanie kureniya na razvitie porazheniy platsenty [Effect of smoking on the development of placental lesions]. Ginekologiya. 2018;20(2):34-40.
  24. Tikkanen M, Riihimäki O, Gissler M. Decreasing incidence of placental abruption in Finland during 1980-2005. Acta Obstet Gynecol Scand. 2012;91(9):1046- 52. https://doi.org/10.1111/j.1600-0412.2012. 01457.x
  25. Guo GL, Zhang YK, Li YL. Epidemiological characteristics and related risk factors on placental abruption in Hebei Province. Zhonghua Liu Xing Bing Xue Za Zhi. 2018;39(12):1621-5. https://doi.org/10.3760/cma.j.is sn.0254-6450.2018.12.016
  26. Goldbart A, Pariente G, Sheiner E, Wainstock T. Identifying risk factors for placental abruption in subsequent pregnancy without a history of placental abruption. Int J Gynaecol Obstet. 2023;161(2):406-11. https://doi.org/10.1002/ ijgo.14446
  27. Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ, et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol. 2005;105(2):239- 45. https://doi.org/10.1097/01.AOG.0000152345.99421.22
  28. Andreeva MD. Patogeneticheski obosnovannaya profilaktika povtornoy prezhdevremennoy otsloyki normal'no raspolozhennoy platsenty [Pathogenetically based prevention of repeated premature abruption of a normally located placenta]. Prakticheskaya meditsina. 2015;2(3):153-5.
  29. Nagorneva SV, Prokhorova VS, Shelaeva EV. Bessimptomnaya otsloyka normal'no raspolozhennoy platsenty v tret'em trimestre beremennosti [Asymptomatic abruption of a normally located placenta in the third trimester of pregnancy]. Zhurnal akusherstva i zhenskikh bolezney. 2017;3:97-104.
  30. Nikitin DA. COVID-19 infektsiya kak faktor riska prezhdevremennoy otsloyki normal'no raspolozhennoy platsenty [COVID-19 infection as a risk factor for premature detachment of a normally located placenta]. Meditsinskiy zhurnal. 2021;3:77-81.
  31. Johnson KM, Smith L, Modest AM. Angiogenic factors and prediction for ischemic placental disease in future pregnancies. Pregnancy Hypertens. 2021;25:12-7. https://doi.org/10.1016/j.preghy.2021.05.011
  32. Adizova SR, Ikhtiyarova GA. Morfologicheskaya kharakteristika platsenty u zhenshchin s preeklampsiey [Morphological characteristics of the placenta in women with preeclampsia]. Novyy den' v meditsine. 2020;2:26-30.
  33. Poon LC, Shennan A, Hyett JA, Kapur A, Hadar E, Divakar H, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on prеeclampsia: A pragmatic guide for first‐trimester screening and prevention. International Journal of Gynecology & Obstetrics. 2019;145:1-33. https://doi. org/10.1002/ijgo.12802135
  34. Ni S, Wang X, Cheng X. The comparison of placental abruption coupled with and without preeclampsia and/or intrauterine growth restriction in singleton pregnancies. J Matern Fetal Neonatal Med. 2021;34(9):1395-400. https://doi. org/10.1080/14767058.2019.1637850
  35. Chumanova OV. Sluchay tyazhyoloy preeklampsii, oslozhnyonnoy razvitiem prezhdevremennoy otsloyki normal'no raspolozhennoy platsenty i dvukhstoronney otsloykoy setchatki [A case of severe preeclampsia complicated by the development of premature detachment of a normally located placenta and bilateral retinal detachment]. Vestnik nauki i obrazovaniya. 2019;8-2:60-3.
  36. Saule O, Shakhnaza T, Nurila A, Aidana B, Asem M, Lyazzat N, i dr. Statisticheskiy analiz prichin prezhdevremennoy otsloyki normal'no raspolozhennoy platsenty [Statistical analysis of the causes of premature detachment of normally located placenta]. Aktual'nye nauchnye issledovaniya v sovremennom mire. 2017;12-8:54-8.
  37. Popova-Petrosyan EV, Dovgan AA, Gaydareva EK, Dovgan MA. Prezhdevremennaya otsloyka normal'no raspolozhennoy platsenty [Premature detachment of a normally located placenta]. Tavricheskiy meditsinskiy i biologicheskiy vestnik. 2023;26(1):36-9. https://doi.org/10.29039/2070-8092-2023-26-1-36-39
  38. Milyaeva NM, Kovalyov VV, Kulikov AV, Bagiyants VA. Progressiruyushchaya otsloyka normal'no raspolozhennoy platsenty: klinicheskoe nablyudenie nesostoyavsheysya materinskoy smerti pri massivnoy krovopotere [Progressive detachment of a normally located placenta: A clinical observation of a failed maternal death with massive blood loss]. Ural’skiy meditsinskiy zhurnal. 2023;22(1):78-84. https://doi.org/10.52420/2071-5943-2023-22-1-78-84
  39. Mastrolia SA, Baumfeld Y, Hershkovitz R, Loverro G, Di Naro E, Yohai D, et al. Bicornuate uterus is an independent risk factor for cervical insufficiency: A retrospective population based cohort study. J Matern Fetal Neonatal Med. 2017;30(22):2705-10. https://doi.org/10.1080/14767058. 2016.1261396
  40. Takami M, Aoki S, Kurasawa K, Okuda M, Takahashi T, Hirahara F. A classification of congenital uterine anomalies predicting pregnancy outcomes. Acta Obstet Gynecol Scand. 2014;93(7):691-7. https://doi.org/10.1111/aogs.12400
  41. Huang K, Yan J, Li X, Lin X, Zhang Q, Luo J, et al. A risk factor analysis and prediction model of placental abruption. Int J Clin Exp Med. 2019;12(11):13023-31.
  42. Nkwabong E, Tchomguie Moussi OS, Fouedjio J. Risk factors for placental abruption. Trop Doct. 2022:494755221116716. https://doi. org/10.1177/00494755221116716
  43. Roberge S, Bujold E, Nicolaides KH. Meta-analysis on the effect of aspirin use for prevention of preeclampsia on placental abruption and antepartum hemorrhage. American Journal of Obstetrics and Gynecology. 2018;218(5):483-9. https://doi.org/10.1016/j.ajog.2017.12.238
  44. Rudakova IS, Shifman EM, Tikhova GP. Faktory riska prezhdevremennoy otsloyki platsenty: retrospektivnoe observatsionnoe sravnitel'noe issledovanie [Risk factors for placental abruption: A retrospective observational comparative study]. Arkhiv akusherstva i ginekologii im. V.F Snegiryova. 2022;9(3):153-61. https://doi.org/10.17816/2313-8726-2022-9-3-153-161
  45. Downes KL, Grantz KL, Shenassa ED. Maternal, labor, delivery, and perinatal outcomes associated with placental abruption: A systematic review. Am J Perinatol. 2017;34(10):935-57. https://doi.org/10.1055/s-0037-1599149
  46. Grebneva OS, Zilber MYu, Volkova AA. Diskussionnye voprosy patogeneza prezhdevremennoy otsloyki platsenty (literaturnyy obzor) [Controversial issues of the pathogenesis of premature placental abruption (literature review)]. Nauchnoe obozrenie. Meditsinskie nauki. 2016;2:33-42.
  47. Boisramé T, Sananès N, Fritz G, Boudier E, Aissi G, Favre R, Langer B. Placental abruption: Risk factors, management and maternal-fetal prognosis. Cohort study over 10 years. Eur J Obstet Gynecol Reprod Biol. 2014;179:100-4. https:// doi.org/10.1016/j.ejogrb.2014.05.026
  48. Petersen SH, Bergh C, Gissler M, Asvold BO, Romundstad LB, Tiitinen A, et al. Time trends in placenta-mediated pregnancy complications after assisted reproductive technology in the Nordic countries. Am J Obstet Gynecol. 2020;223(2):226.e1-226.e19. https://doi.org/10.1016/j.ajog.2020.02.030
  49. Nadeev AP, Karpov MA, Kostina LYu, Pozdnyakova SV. Issledovanie amputirovannykh (ekstirpirovannykh) matok i posledov: analiz prichin i morfologicheskaya kharakteristika [Examination of amputated (extirpated) uterus and placenta: Analysis of causes and morphological characteristics]. Sibirskiy meditsinskiy vestnik. 2020;4:30-5.
  50. Samoylenko YuV, Fomina IV. Obzor sluchaya polnoy otsloyki normal'no raspolozhennoy platsenty i antenatal'noy gibeli ploda na fone tyazhyoloy preeklampsii i HELLP-sindroma [Review of a case of complete detachment of a normally located placenta and antenatal fetal death in the presence of severe preeclampsia and HELLP syndrome]. Molodyozhnyy innovatsionnyy vestnik. 2019;8(2):152-3.
  51. Negmatullaeva MN. Lechenie gemorragicheskogo shoka pri akusherskikh krovotecheniyakh [Treatment of hemorrhagic shock in obstetric bleeding]. Aktual'nye problemy teoreticheskoy i klinicheskoy meditsiny. 2022;1:36-8.
  52. Mozheyko LF, Markovskaya TV, Korshikova RL, Dyadichkina OV, Fedotova EV, Stasevich SM. Matka Kyuvelera: vozmozhnost' sokhraneniya reproduktivnogo organa (klinicheskiy sluchay) [Kuveler's uterus: The possibility of preserving the reproductive organ (clinical case)]. Reproduktivnoe zdorov'e. Vostochnaya Evropa. 2020;10(4):518-24.
  53. Markovskaya TV. DVS-sindrom v akushersko-ginekologicheskoy praktike [DIC-syndrome in obstetric-gynecological practice]. Meditsinskie novosti. 2019;6:3-10.
  54. Iskakov SS, Seydullaeva LA, Eszhanova AA, Razumova RR, Khalmuratova KZh. Sovremennye faktory riska akusherskikh krovotecheniy [Modern risk factors for obstetric bleeding]. AMZh. 2020;105(3):184-9.
  55. Kamilova MYa, Aminzoda NZ. Osobennosti diagnostiki i lecheniya akusherskikh krovotecheniy, soprovozhdayushchikhsya koagulopatiey [Features of diagnosis and treatment of obstetric bleeding accompanied by coagulopathy]. Vestnik Avitsenny [Avicenna Bulletin]. 2020;22(1):120-6. https://doi. org/10.25005/2074-0581-2020-22-1-120-126
  56. Waters JH, Bonnet MP. When and how should I transfuse during obstetric hemorrhage? Int J Obstet Anesth. 2021;46:102973. https://doi.org/10.1016/j. ijoa.2021.102973

Authors' information:


Salimova Zumrat Dzhamshedovna,
Postgraduate Student of the Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University
ORCID ID: 0000-0001-8276-8678
E-mail: zumrat.9595@mail.ru

Dodkhoeva Munavvara Fayzulloevna,
Academician of NAST, Doctor of Medical Sciences, Full Professor, Professor of the Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University
Researcher ID: AAC-4784-2019
ORCID ID: 0000-0001-9373-4318
SPIN-код: 9749-6174
Author ID: 313026
E-mail: dodkho2008@mail.ru

Saydalieva Dilafruz Alovuddinovna,
PhD Student of the Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-4979-7896
E-mail: dilaksaidali@gmail.com

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:


Dodkhoeva Munavvara Fayzulloevna
Academician of NAST, Doctor of Medical Sciences, Full Professor, Professor of the Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (918) 612606

E-mail: dodkho2008@mail.ru

Materials on the topic: