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Clinical features of abruptio placentae as a prominent cause of cerebral palsy

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Title: Clinical features of abruptio placentae as a prominent cause of cerebral palsy
Authors: Yamada, Takahiro Browse this author →KAKEN DB
Yamada, Takashi Browse this author →KAKEN DB
Morikawa, Mamoru Browse this author →KAKEN DB
Minakami, Hisanori Browse this author →KAKEN DB
Keywords: Abdominal pain
Cerebral palsy
Abruption placentae
Vaginal bleeding
Proteinuria
Issue Date: Nov-2012
Publisher: Elsevier
Journal Title: Early Human Development
Volume: 88
Issue: 11
Start Page: 861
End Page: 864
Publisher DOI: 10.1016/j.earlhumdev.2012.06.008
PMID: 22805996
Abstract: Background: Although abruptio placentae causes hypoxia in the infant and thus leading to cerebral palsy (CP), its incidence and clinical features at a nation wide level have not been demonstrated. Aims: To determine the proportion of abruptio placentae among antenatal and intrapartum causative factors leading to cerebral palsy (CP) and clinical features of such abruptio placentae. Study design: A review was conducted in 107 infants with CP in whom CP was determined to be due to antenatal and or intrapartum hypoxic conditions by the Japan Council for Quality Health Care until April 2012. Results: Abruptio placenta was responsible for 28 (26%) of the 107 CP infants, and was the single leading causative factor of CP. Of these 28 women, 22 (79%) exhibited non-reassuring fetal status on admission to obstetric facilities at 36.2 ± 2.6 weeks of gestation and had neonates with umbilical cord arterial blood pH (base excess) of 6.728 ± 0.164 (-25 ± 5.4 mmol/L). In these 22 women, strong abdominal pain and/or profuse vaginal bleeding occurred 159 ± 99 min prior to admission to an obstetric facility, and the interval until delivery after admission was 47 ± 31 min. Hypertension or isolated proteinuria preceded clinical events in one (4.5%) and five (23%) of these 22 women, respectively. Conclusions: Abruptio placentae was responsible for CP in one quarter of all cases determined to be due to antenatal and/or intrapartum hypoxic conditions in Japan. New strategies to shorten the interval until admission to an obstetric facility after onset of symptoms are urgently needed.
Type: article (author version)
URI: http://hdl.handle.net/2115/50555
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 山田 崇弘

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