Pregnancy outcome in severe XXXX .

@entity1 @entity245 @entity5869 @entity204 @entity1168 @entity306
OBJECTIVE: To determine the relationship between decision to delivery interval and perinatal outcome in severe @entity5869 . DESIGN: A case-control study. SETTING: Large inner city teaching hospital. METHODS: Retrospective case note review of pregnancies terminated following severe placental aburption and fetal @entity1168 . One year paediatric follow up by case note review or postal questionnaire. The differences in outcome ( @entity204 or @entity306 ) were examined using non-parametric and univariate analysis for the following time periods--times from onset of symptoms to delivery, onset of symptoms to admission, admission to delivery, onset @entity1168 to delivery and decision to delivery interval. MAIN OUTCOME MEASURES: Prenatal @entity204 or survival with @entity306 . RESULTS: Thirty-three @entity1 with singleton pregnancies over 28 weeks of gestation, admitted with clinically overt @entity5869 , where delivery was effected for fetal @entity1168 . Eleven of the pregnancies had a poor outcome (cases), eight @entity1 died and three surviving @entity1 have @entity306 . Twenty-two pregnancies had a good outcome (controls): survival with no @entity245 . No statistically significant relationship was found between maternal age, parity, gestation, or birthweight and a poor outcome. A statistically significant relationship between time from decision to delivery was identified (P = 0.02, Mann-Whitney U test). The results of a univariate logistic regression for this variable suggest that the odds ratio of a poor outcome for delivery at 20 minutes compared with 30 minutes is 0.44 (95% CI 0.22-0.86). Fifty-five percent of @entity1 were delivered within 20 minutes of the decision to deliver. Serious maternal morbidity was rare. CONCLUSION: In this small study of severe @entity5869 complicated by fetal @entity1168 , a decision to delivery interval of 20 minutes or less was associated with substantially reduced neonatal morbidity and mortality.
