271 Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2006, 150(2):271–273. © Selected pregnancy variables in women with placental abruption SELECTED PREGNANCY VARIABLES IN WOMEN WITH PLACENTAL ABRUPTION Martin Prochazka a *, Marek Lubusky a , Ludek Slavik b , Petr Hrachovec a , Petr Zielina a , Milan Kudela a , Pelle G. Lindqvist c a Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic b Department of Hematooncology, Faculty of Medicine and Dentistry, Palacky University, Olomouc c Department of Obstetrics and Gynaecology, University Hospital MAS, Malmö, Sweden e-mail: prochazka-martin@post.cz Received: August 13, 2006; Accepted: October 30, 2006 Key words: Hereredity factors in thrombosis/Placental abruption/Fetal loss/Risk factors Objective: The aim of this study was to investigate risk factors for placental abruption and to determine if anamnestic variables such as inherited thrombosis or recurrent fetal loss might be used as a predictor for placental abruption. Methods: A retrospective case-control study at the University Hospital, Palacky University, Olomouc, Czech Republic. One hundred and eighty women with placental abruptio out of 20,175 deliveries (0.79 %) who were com- pared to 196 unselected pregnant women. A detailed anamnesis was taken. Results: Compared to controls, women with placental abruptio had a 12-fold increased prevalence of prior recur- rent fetal loss and a 6-fold increased prevalence of inherited thrombosis. Conclusions: We found that recurrent fetal loss, and inherited thrombosis may be significant risk factors for pla- cental abruptio. INTRODUCTION Premature separation of the placenta occurs in only 1 % of all pregnancies, yet it is an important cause of stillbirth, preterm delivery, early neonatal death and even maternal death 1 . Placental abruptio accounts for 20 % to 25 % of antepartum hemorrhages. The perinatal mor- tality rate varies between 2 % and 67 %, depending on gestational age, fetal weight, and the degree of abruptio. Over 50 % of all perinatal deaths occur before delivery 2 . Placental abruptio is defined as the separation of a nor- mally implanted placenta, usually by hemorrhage into the decidua basalis. Abruptio itself usually manifests as pain- ful uterine bleeding and uterine irritability, sometimes in conjunction with fetal distress and maternal coagulation abnormalities. The aim of our study was determine risk factors and to identify potential predictors of placental abruption. METHODS We identified 180 women out of 20,175 deliveries (0.79 %) with a confirmed diagnosis of placental abrup- tio at the Department of Obstetrics and Gynecology, University Hospital, Olomouc, during a 14-year period (January 1991 to July 2004). All 180 women were ap- proached by letter to participate in the study and 142 (79 %) representing 154 babies accepted. Women par- ticipating in the study were interviewed in person and a detailed history of the situation before the index preg- nancy was made. Also, all medical records were reviewed. Gestational age was routinely estimated by ultrasound examination in mid-pregnancy. The control group was collected between January 2003 and March 2004. Every tenth woman giving birth at the delivery unit was ap- proached to participate in the study. Two hundred and six women with uncomplicated pregnancies were approached to participate in the study. Ten women declined to partici- pate, and thus, 196 women were included in the control group. A detailed medical history of this group was also taken before delivery as part of the clinic routine and their medical records were reviewed. The Ethics Committee of the Medical Faculty of Palacký University approved the study design, and informed consent was obtained from all participants. Characteristics The mean age for study group and the control group was 27.5 years (± 5.4) and 28.8 years (± 5.1). The neonates from the study group were at a significantly lower gesta- tional age and had a lower birth weight than the control group (33.5 ± 4.8 and 39.1 ± 2.0 weeks) and 2164 g ± 984 and 3385 g ± 539. The pH of the umbilical artery was not statistically different between the two groups (7.30 ± 0.14 [n = 106] and 7.32 ± 0.06 [n = 103] cases, p < 0.18). The diagnosis of placental abruptio was based on clinical examination. Women usually presenting with a combination of profuse vaginal bleeding and painful con- tractions. All placentas were examined macroscopically. Recurrent pregnancy loss was defined as three or more first trimester losses, one second trimester fetal loss with