Placental Abruption

Facts

-Placental abruption (also referred to as abruptio placentae) refers to partial or complete placental detachment prior to delivery of the fetus.

-The immediate cause is rupture of maternal blood vessels in the decidua basalis.

-Risk factors: previous abruption, cocaine use, smoking, hypertension, uterine anomalies,

-Classic Symptoms and Signs: vaginal bleeding, abdominal pain, contractions, uterine  tenderness, a nonreassuring fetal heart rate (FHR) tracing

-Severe abruption can lead to Disseminated Intravascular Coagulation (DIC).

-Classic Ultrasound Finding: Identification of a Retroplacental Hematoma/blood clot.

-Management:

Fetal heart rate nonreassuring, vaginal delivery or C-section.

Fetal heart rate is reassuring but mother unstable: vaginal delivery or C-section.

Mother & Fetus stable, less than 34 weeks gestation: conservative management

Mother & Fetus stable, at 34 – 36 weeks gestation: delivery

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