Efecto de la preeclampsia en la morbilidad materna y neonatal asociada al desprendimiento prematuro de placenta.

Abstract

Introduction: Premature placental abruption, present in 0.5–2% of births and responsible for 2.28% of maternal mortality in Ecuador, is mainly associated with hypertensive disorders, especially preeclampsia. Objective: To determine the effect of preeclampsia on maternal and neonatal morbidity associated with premature placental abruption in pregnant women treated at the Guayaquil University General Hospital during the period from 2020 to 2024. Methodology: This research study had an observational, analytical, retrospective, and cross-sectional design. Results: A total of 341 pregnant women with premature placental abruption were identified. Most had 1–2 pregnancies (59.8%) and vaginal deliveries (54.8%). The prevalence of preeclampsia was 17.8%, with mild cases predominating (48.8%). The most frequent complication was hemorrhage (67.4%), and the severity of preeclampsia was significantly associated with hemorrhage (OR = 3.45; 95% CI: 1.23–4.56), hysterectomy (OR = 6.0; 95% CI: 0.91–39.4), and maternal death (OR = 4.25; 95% CI: 1.26–8.45). In the multivariate analysis, the following risk factors were identified: maternal age > 35 years (OR = 2.65; 95% CI: 1.01–6.93), chronic hypertension (OR = 4.12; 95% CI: 1.52–11.15), progression > 7 days (OR = 3.38; 95% CI: 1.17–9.74), hemorrhage (OR = 3.21; 95% CI: 1.09–9.48), hysterectomy (OR = 4.87; 95% CI: 1.03–22.96), and maternal death (OR = 5.94; 95% CI: 1.07–32.91). Conclusion: Premature placental abruption is associated with a high prevalence of preeclampsia, mainly in its mild form, associated with complications such as hemorrhage, hysterectomy, maternal mortality, and preterm delivery.