Placenta Abruptio

Question 1

What is placenta abruptio?

Answer 1

Placenta abruptio is the premature separation of the placenta from the uterine wall.

Question 2

What are common symptoms of placenta abruptio?

Answer 2

vaginal bleeding,
abdominal pain, and
uterine contractions.
Symptoms of shock
Back ache
Lack of fetal movement

Question 3

The main risk factor for placenta abruptio

Answer 3

hypertension
Severe eclampsia and preeclampsia
Trauma
Advanced maternal age
Fibroid
Folic acid deficiency
Short umbilical cord
Chorioaminionitis
Cocain use

Question 4

What is the primary complication associated with placenta abruptio?

Answer 4

The primary complication is fetal distress or stillbirth.

Question 5

True or False: All cases of placenta abruptio require immediate delivery.

Answer 5

False

Question 6

What imaging technique is commonly used to diagnose placenta abruptio?

Answer 6

Ultrasound

Question 7

Types Placenta abruptio is classified into

Answer 7

Revealed : bleeding is revealed through the vagina

Concealed : no visible blood in the vagina. But there is internal bleeding

Mixed : both

Question 8

What is the typical management for mild cases of placenta abruptio?

Answer 8

Monitoring and bed rest

Question 9

What is the role of tocolytics in treating placenta abruptio?

Answer 9

Tocolytics are used to relax the uterus and reduce contractions.

Question 10

What is a possible consequence of untreated severe placenta abruptio?

Answer 10

Maternal shock or death

Question 11

What is the term for the area where the placenta detaches from the uterus in cases of abruptio?

Answer 11

Retroplacental hemorrhage

Question 12

What is the preferred mode of delivery in cases of severe placenta abruptio?

Answer 12

Cesarean section

Question 13

Active management of placenta abruptio

Answer 13

Analgesic such as pethidine 100 mg is given and blood is taken for necessary investigations. Blood is also cross-matched immediately and at least 6 units should be requested. In the meantime an intravenous infusion of plasma could be commenced if bloodisnotimmediatelyavailable.

Thevaginalrouteistherecommendedmethodof choice for delivery but caesarean section is usually indicated if the fetus is still alive. Caesareansectionisalsothemethodofchoiceif there are obstetric indications like cephalopelvic disproportionor transverse lie.

Heamorrhage
oxytocic infusion containing 20 units of syntocinon in 500 ml 5% dextrose.

Coagulation defects

Forearlydetectionof coagulation defects, clotting time should be done every 2-4 hours. Ifthe patient continues to bleed afterdeliveryandtheclottingtimeismorethan10 minutes, coagulation defect is invariably the cause. Fibrinolysin test and platelet count should also be performed. The bedside clotting time
observation is done by placing 2ml of blood in a drytesttubeandregularlyinvertthetubebetween the finger and thumb. The fibrinogen level will in coagulation defect fall below 100-150mg/100 ml (normal level in pregnancy is between 300- 700mg/lOOml).Ifhypo-orafibrinogenaemia is confirmed from the above tests which include clotting time, fresh blood or pure

Question 14

What should be monitored closely in a patient diagnosed with placenta abruptio?

Answer 14

Fetal heart rate and maternal vital signs

Question 15

What is the most common type of bleeding associated with placenta abruptio?

Answer 15

Dark red vaginal bleeding