Objective To investigate the risk factors for placental abruption in singleton pregnancy with hypertensive dis-orders of pregnancy(HDP).Methods The clinical data of 1 595 HDP patients who met the inclusion criteria and were hospitalized in the Department of Obstetrics and Gynecology in the Second Affliated Hospital of Anhui Medical Universi-ty,from January 2014 to January 2022,were retrospectively analyzed.According to the occurrence of placental abrup-tion,they were divided into study group(with placental abruption,34 cases)and control group(without placental ab-ruption,1 561 cases).Demographic characteristics,clinical characteristics and laboratory test results were recorded.Univariate and multivariate logistic regression models were used to analyze the risk factors of HDP patients with placental abruption,and an ROC curve was constructed to evaluate the predictive efficacy.Results Among 1 595 HDP patients enrolled in this study,34 were diagnosed with placental abruption(2.13％).Compared with the control group,the study group had higher levels of D-dimer(P=0.005),serum creatinine(P=0.044),blood urea nitrogen(P=0.043)and aspartate aminotransferase(P=0.014),and lower levels of platelet count(P=0.012)and fibrinogen(P=0.011).Se-rum D-dimer level(P=0.009),fibrinogen level(P＜0.001)and HDP types[severe preeclampsia(P=0.033),ec-lampsia(P=0.001)]were the influencing factors of placental abruption in HDP patients.Among them,fibrinogen had the highest predictive sensitivity(55.9％)and D-dimer had the highest specificity(84.2％).The sensitivity of the com-bination of D-dimer and fibrinogen was higher than that of the individual risk factors(61.8％).The AUC of HDP types was the lowest[0.617(95％CI:0.515-0.720)],and the AUC of D-dimer+fibrinogen+HDP types was the highest[0.735(95％CI:0.639-0.831)].Conclusion Different types of HDP have a significant impact on placental abrup-tion in singleton pregnancy.If fibrinogen is decreased and D-dimer is increased,placental abruption should be highly suspected in singleton pregnancy with HDP.
Hypertensive disorders of pregnancyPlacental abruptionRisk factorsD-dimerFibrinogen
维普
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