Chronic abruption-oligohydramnios sequence
Elliott, J.P.; Gilpin, B.; Strong, T.H.; Finberg, H.J.
Journal of Reproductive Medicine 43(5): 418-422
1998
ISSN/ISBN: 0024-7758 PMID: 9610464 Document Number: 487019
Objective: To determine outcome in patients with chronic abruption. Study Design: A retrospective review was performed of all patients delivering at a tertiary medical center during a 54-month period. All patients with a diagnosis of placental abruption with oligohydramnios or ruptured membranes were included. Chronic abruption-oligohydramnios sequence (CAOS) was defined by the following criteria: (1) clinically significant vaginal bleeding in the absence of placenta previa or other identifiable source of bleeding, (2) amniotic fluid volume initially documented as normal, and (3) oligohydramnios (amniotic fluid index ltoreq 5) eventually developing without concurrent evidence of ruptured membranes. Results: Twenty-four patients with CAOS were identified. Fourteen had first evidence of abruption at < 20 weeks' gestational age. A clot was identified between the chorion and uterus in 18/24. The mean gestational age at the first bleeding episode was 19.4 +- 5.5 (SD) weeks, with the mean gestational age at delivery 28.1 +- 4.5 weeks. Preterm premature membrane rupture occurred in 15/24. In these 15 there was a mean of 11.5 +- days between the diagnosis of oligohydramnios and of ruptured membranes. Patients whose first blood occurred at < 20 weeks' gestation delivered at a gestational age of 26.1 +- 2.9 weeks versus 33.0 +- 5.3 weeks for the control group. Conclusion: CAOS can occur in pregnancies complicated by abruptio placentae. If it develops, the mean gestational age at delivery is 28 weeks.