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BRIEF RESEARCH REPORT article

Front. Med.
Sec. Obstetrics and Gynecology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1530062

Intrauterine death from placental abruption: influence of labor duration and mode of delivery on maternal outcomes

Provisionally accepted
Louis VAN HEES Louis VAN HEES 1*Robin Danger Robin Danger 2Caroline Turbelin Caroline Turbelin 3
  • 1 Vivalia - Libramont Hospital, Bastogne, Belgium
  • 2 University Hospital of Martinique, Fort-de-France, Martinique
  • 3 Department of Anesthesia and Resuscitation, CHU Angers, Angers, Pays de la Loire, France

The final, formatted version of the article will be published soon.

    Intrauterine fetal death (IUFD) caused by retroplacental hematoma (RPH) can lead to serious maternal complications including coagulopathies and hemorrhage. A prolonged diagnostic-toexpulsion delay may increase coagulation risks. Vaginal delivery (VD) prolongs this delay, while cesarean delivery poses higher hemorrhagic risks. This study aimed to assess the relationship between expulsion delay and complications, identify a time threshold for increased risks, and evaluate VD feasibility.We conducted a retrospective single-center study at the University Hospital of Martinique, including all patients presenting with RPH and IUFD between January 2003 and December 2022. Complications were defined by a composite criterion, including the need for blood transfusion, severe anemia or admission to an intensive care unit.VD was attempted in 26 of the 27 patients included and successfully achieved in 85% of the cases. All cesarean deliveries resulted in complications (p=0,12), with 50% experiencing severe hemorrhage, compared to 21.7% of VD cases (p=0,23). No statistically significant association was found between the expulsion delay and the occurrence of complications (p=0,20). A low fibrinogen level upon admission was associated with an increased risk of severe hemorrhage (p=0,01) and complications (p=0,01).In this study, no evidence was found to suggest an association between the diagnostic-to-expulsion interval and maternal complications. Low fibrinogen levels at admission appear to be a prognostic factor for severe hemorrhage and could have therapeutic implications. Vaginal delivery remains feasible even in the presence of coagulopathies at admission.

    Keywords: Placental abruption, Cesarean delivery, Intrauterine fetal death, Postpartum Hemorrhage, vaginal delivery, complication

    Received: 18 Nov 2024; Accepted: 06 Jan 2025.

    Copyright: © 2025 VAN HEES, Danger and Turbelin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Louis VAN HEES, Vivalia - Libramont Hospital, Bastogne, Belgium

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