Open AccessPerinatal mortality and case fatality after placental abruption in Norway 1967‐1991
Author(s) -
Rasmussen Svein,
Irgens Lorentz M.,
Bergsjø Per,
Dalaker Knut
Publication year - 1996
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016349609047092
Subject(s) - placental abruption , medicine , obstetrics , case fatality rate , perinatal mortality , gestation , population , gestational age , pregnancy , infant mortality , mortality rate , gynecology , pediatrics , fetus , surgery , genetics , environmental health , biology
Study objective To study national secular trends in Norway of perinatal mortality and case fatality due to placental abruption (PA) and associations with cesarean section (CS). Design A population based cohort study. Setting The Medical Birth Registry of Norway. Patients 9,592 cases of placental abruption (PA) of a total of 1,446,154 births notified in Norway 1967‐1991. Main measures Comprehensive perinatal mortality (all stillbirths ≥ 16 weeks of gestation and early neonatal deaths) and standard perinatal mortality (all stillbirths ≥ 28 weeks of gestation and all early neonatal deaths). Case fatality rate. Main results From 1967 through 1991, the standard perinatal mortality rate due to placental abruption (PA) in Norway decreased from 2.5 per 1000 births (13.5% of all deaths) in 1967 to 0.9 (13.2%) in 1991. The comprehensive perinatal mortality rate decreased from 3.2 to 1.7 per 1000. The proportion of all perinatal deaths due to PA increased from 11.4% in 1967‐1971 to 13.9 in 1987‐1991. The case fatality rate decreased from 470.8 per 1000 cases in 1967‐71 to 217.0 in 1987‐91 and decreased in all gestational age categories. Case fatality in PA with cesarean section (CS) was generally lower than in PA without CS, regardless of gestational age. Conclusions Placental abruption is an important cause of perinatal mortality in Norway. Our results are in favor of an active approach with frequent use of cesarean section, also at lower gestational ages. The decreasing case fatality rate by year of birth in all gestational age groups may be attributed to improved obstetric and perinatal care.