본 국립의료원 산부인과에서 시행한 태반조기박리환자 92예에 대한 임상적 고찰을 하여 다음과 같은 결론을 얻었다. 1) 태반조기박리의 빈도는 총 분만예 18,867예중 92예로서 0.49%이었다. 2) 태반조기박리 환자의 연령별 분표는 30~34세군이 35.9%로 제일 많은 비율이었다. 3) 초산부에서의 빈도는 14.1%이었고 경산부가 85.9%이었으며 임신력이 5회 이상인 경산부는 초산부의 약 2배이었다. 4) 재태기간별 분포는 33주~36주가 24예로 26.1%를 차지하였고 36주이하인 경우가 52예로 56.5%를 점하여 조산의 경향을 보였다. 5) 원인적 요소는 원인미상이 45.6%, 임신중독증 및 고혈압이 43.5%, 외상 7.6%의 순위였다. 6) 환자의 증상중 가장 많았던 것은 질출혈(100%)이었고 동통 및 강직성동통이 71.7%, 태아가사상태 52.2%의 순위이었다. 7) 증상시작부터 분만까지의 시간은 태아사망율과 밀접한 관계를 가지며 6시간 이후에 분만하면 약 3/4의 태아가 사망하였다. 8) 합병증이 있었던 27예중 출혈 및 허탈이 4.3%, 혈액응고장애가 3.3%, 급성신부전이 2.2%에서 발생하였다. 9) 분만방식은 질식분만을 시행한 예가 93.5%이었고 제왕절개술은 4.3%이었으며 자궁적출술도 2.2%에서 시행하였다. 10) 주산기사망율은 60예로 65.2%이었고 사산은 58.7%, 신생아사망은 6.5%이었으며, 모성사망율은 1예로써 1.1%이었다.

There are a number of causes of bleeding during the latter half of pregnancy with life threatening situation. Abruptio placentae is one of most essential & serious complications in pregnancy in dealing with maternal mortality and fetal mortality in our country. 1) The incidence of abruptio placentae which occured among total 18,867 deliveries in National Medical Center in Seoul during the period of 16 years was 0.49%. 2) The majority of abruptio placentae occured between age 30 and 34. 3) Incidence among women gravida 5 and over was twice that of primiparous women. High parity was the most important predisposing factor in our series. 4) It was interesting to identify that more than half(56.5%) of cases of abruptio placentae had a tendency of premature labor occuring between 21 and 36 weeks of gestational period. 5) The disorder was associated with preeclampsia and other hypertensive conditions in 43.5% of cases and trauma is the next important etiological factor. 6) The most common symptom was vaginal bleeding(100%) and there was varying degrees of tenderness on abdominal palpation in 71.7% cases and fetal distress in 52.2% of cases. 7) Fetal mortality had close relationship with the duration from onset to delivery. The duration of symptoms was more than 6 hours and about three quarters of baby died in perinatal period. 8) Among the 27 complicated cases of abruptio placentae, hemorrhage and shock occured in 4.3%, blood coagulation defect in 3.3% and acute renal failur in 2.2%, respectively. 9) Only 4 cases of section was performed for fetal distress, abnormal presetation and no progress of labor, and all others(93.5%) being vaginal deliveries. 10) Perinatal mortality rate was 65.2% including stillbirth(58.7%) and neonatal death(6.5%). Considerable percentage of mortality was attributed to complications associated prematurity. Maternal mortality was 1.1% of total cases. Maternal mortality had significantly decreased in recent years.