Volume 22 Issue 8
Aug.  2024
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Article Navigation >  Chinese Journal of General Practice  > 2024  >  22(8): 1367-1370
WANG Wenxin, WANG Ruolan, FANG Yuanyuan, SHEN Qingmei, WANG Meng, YANG Kuanying, FAN Yijun. Risk prediction of placental abruption in singleton pregnancy with hypertensive disorders of pregnancy[J]. Chinese Journal of General Practice, 2024, 22(8): 1367-1370. doi: 10.16766/j.cnki.issn.1674-4152.003638
Citation: WANG Wenxin, WANG Ruolan, FANG Yuanyuan, SHEN Qingmei, WANG Meng, YANG Kuanying, FAN Yijun. Risk prediction of placental abruption in singleton pregnancy with hypertensive disorders of pregnancy[J]. Chinese Journal of General Practice, 2024, 22(8): 1367-1370. doi: 10.16766/j.cnki.issn.1674-4152.003638
shu

Risk prediction of placental abruption in singleton pregnancy with hypertensive disorders of pregnancy

doi: 10.16766/j.cnki.issn.1674-4152.003638

  • Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China

Funds:

 2208085MH205

 2021LCZD05

  • Received Date: 2023-12-28
    Available Online: 2024-11-19
    Abstract
  •   Objective  To investigate the risk factors for placental abruption in singleton pregnancy with hypertensive disorders of pregnancy (HDP).  Methods  The clinical data of 1 595 HDP patients who met the inclusion criteria and were hospitalized in the Department of Obstetrics and Gynecology in the Second Affiliated Hospital of Anhui Medical University, from January 2014 to January 2022, were retrospectively analyzed. According to the occurrence of placental abruption, they were divided into study group (with placental abruption, 34 cases) and control group (without placental abruption, 1 561 cases). Demographic characteristics, clinical characteristics and laboratory test results were recorded. Univariate and multivariate logistic regression models were used to analyze the risk factors of HDP patients with placental abruption, and an ROC curve was constructed to evaluate the predictive efficacy.  Results  Among 1 595 HDP patients enrolled in this study, 34 were diagnosed with placental abruption (2.13%). Compared with the control group, the study group had higher levels of D-dimer (P=0.005), serum creatinine (P=0.044), blood urea nitrogen (P=0.043) and aspartate aminotransferase (P=0.014), and lower levels of platelet count (P=0.012) and fibrinogen (P=0.011). Serum D-dimer level (P=0.009), fibrinogen level (P < 0.01) and HDP types [severe preeclampsia (P=0.033), eclampsia (P=0.001)] were the influencing factors of placental abruption in HDP patients. Among them, fibrinogen had the highest predictive sensitivity (55.9%) and D-dimer had the highest specificity (84.2%). The sensitivity of the combination of D-dimer and fibrinogen was higher than that of the individual risk factors (61.8%). The AUC of HDP types was the lowest [0.617 (95% CI: 0.515-0.720)], and the AUC of D-dimer+fibrinogen+HDP types was the highest [0.735 (95% CI: 0.639-0.831)].  Conclusion  Different types of HDP have a significant impact on placental abruption in singleton pregnancy. If fibrinogen is decreased and D-dimer is increased, placental abruption should be highly suspected in singleton pregnancy with HDP.

     

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