{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T03:47:31Z","timestamp":1782186451050,"version":"3.54.5"},"reference-count":8,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T00:00:00Z","timestamp":1782000000000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate maternal characteristics, management practices, and outcomes of placental abruption according to facility type in Japan, and to assess the effectiveness of the country's centralized perinatal care system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study used the Diagnosis Procedure Combination database from acute\u2010care hospitals between May 2014 and April 2024. Cases coded with ICD\u201010 O45.0 or O45.9 were included, excluding those with multiple gestations or placenta previa. Patients were categorized into Comprehensive Perinatal Medical Centers (CPMCs) and Regional Perinatal Medical Centers\/General Hospitals (non\u2010CPMCs). The primary outcomes were severe and serious maternal complications as defined by Ananth et\u00a0al. Secondary outcomes included mode of delivery, hysterectomy, transfusion use and volume, maternal and fetal mortality, intensive care unit admission, estimated blood loss at delivery, and length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 771 eligible cases, 257 (33.3%) were admitted to CPMCs and 514 (66.7%) to non\u2010CPMCs. Referrals (78.2% vs. 68.5%) and ambulance transports (63.0% vs. 37.5%) were significantly more frequent in CPMCs. Severe maternal complications were more common in CPMCs (30.0% vs. 18.3%), particularly coagulopathy and hypovolemic shock, many of which were present at admission. Despite higher baseline severity, rates of serious maternal complications and maternal mortality did not differ. The mean length of hospital stay was shorter in CPMCs (6.0 vs. 6.7\u2009days).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Severe placental abruption cases appear to be effectively centralized within this multicenter cohort. The advanced maternal emergency capacity of CPMCs may mitigate morbidity despite higher baseline severity, supporting the functional role of perinatal regionalization within this network.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70378","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T06:32:23Z","timestamp":1782109943000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maternal Complications and Facility\u2010Level Differences in the Management of Placental Abruption in Japan: A Retrospective Analysis Using a Multicenter\n                    <scp>DPC<\/scp>\n                    Database"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9542-8955","authenticated-orcid":false,"given":"Shiori","family":"Hirano","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Saiseikai Matsusaka General Hospital  Matsusaka Mie Japan"},{"name":"Department of Obstetrics and Gynecology Mie University School of Medicine  Tsu Mie Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Kanda","sequence":"additional","affiliation":[{"name":"Department of Cardiology Chiba University Graduate School of Medicine  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5270-5182","authenticated-orcid":false,"given":"Masafumi","family":"Nii","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Mie University School of Medicine  Tsu Mie Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9773-2520","authenticated-orcid":false,"given":"Eiji","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Mie University School of Medicine  Tsu Mie Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoaki","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Saiseikai Matsusaka General Hospital  Matsusaka Mie Japan"},{"name":"Department of Obstetrics and Gynecology Mie University School of Medicine  Tsu Mie Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0918-8911","authenticated-orcid":false,"given":"Takahiro","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Healthcare Management Research Center Chiba University Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,21]]},"reference":[{"issue":"4","key":"e_1_2_13_2_1","first-page":"234","article-title":"The Perinatal Care System in Japan","volume":"54","author":"Unno N.","year":"2011","journal-title":"Japan Medical Association Journal"},{"issue":"6","key":"e_1_2_13_3_1","first-page":"669","article-title":"Current Status and Challenges of Perinatal Emergency Medicine","volume":"55","author":"Nakai A.","year":"2025","journal-title":"Perinatal Medicine (Tokyo)"},{"key":"e_1_2_13_4_1","unstructured":"T.Ikeda \u201cResearch Report on Consolidation and Prioritization of Perinatal Centers for the 8th Medical Care Plan and Securing and Education of Perinatal Physicians [in Japanese]\u201d(2021) https:\/\/mhlw\u2010grants.niph.go.jp\/project\/164653."},{"key":"e_1_2_13_5_1","unstructured":"Resuscitation Promotion Foundation \u201cPerinatal Emergency Care in Prehospital Settings: National Survey and Recommendations for Perinatal Emergency Education [in Japanese]\u201d(2017) https:\/\/fasd.jp\/pages\/17\/."},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12199-020-00889-y"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.09.069"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2019.07.003"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.05.004"}],"container-title":["Journal of Obstetrics and Gynaecology 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