Module 8 (Exam 3) Abruptio Placentae

Question 1

Abruptio Placentae

Answer 1

Seperation of a normally implanted placenta before the fetus is born. Occurs in about 1 in 200 pregnancies. Results in 10-15% of perinatal deaths.

Question 2

Abruptio Placentae is more common in:

Answer 2

1. Maternal hypertension (vessels contracted)
2. Smoking and drug use (cocaine) (vasoconstrictor)
3. Multiparity
4. Short umbilical cord
5. Abdominal trauma
6. PROM
7. Previous abruptions
8. Advanced maternal age
9. Coagulopathies

Question 3

Classficiations of Abruptio Placentae

Answer 3

1. Concealed hemorrhage
2. Apparent (visible) hemorrhage

Question 4

Concealed Hemorrhage

Answer 4

Central or partial seperation in the middle of the placenta

Question 5

Apparent (visible) Hemorrhage

Answer 5

1. Marginal or partial: seperation at the edge of the placenta
2. Complete: total seperation of the placenta

Question 6

Signs and Symptoms of Abruptio Placentae

Answer 6

1. Bleeding
2. Uterine tenderness and irritability
3. Uterus is rigid, “boardlike” to palpation
4. Abdominal or low back pain
5. High uterine resting tone
6. Signs of hypovolemic shock (c-section)
7. Non-reasurring EFM
   
   1. Late decelerations, decreased variability, bradycardia

Question 7

Therapeutic Management of Abruptio Placentae

Answer 7

1. Hospitalization
2. Conservative management: IVs, EFM with IUCP, bed rest, tocolytics, steriods to mature fetal lungs
3. Emergent Management: C-section, Rhogam

Question 8

Previa VS Abruption

Answer 8

1. Onset quiet & varied (p) VS sudden and stormy (a)
2. Bleeding present (p) VS may be concealed (a)
3. Pain only in labor (p) VS severe and stead (a)
4. Uterine tenderness absent (p) VS present (a)