Placental Abruption Flashcards
What is Placental abruption?
The premature separation of placenta from the uterine wall
What does placental abruption result in?
Maternal haemorrhage into the intervening space
What are the main risk factors for placental abruption?
~~~
A previous abruption
Blood pressure
Rupture of the membranes
U
Polyhydraminos
Trauma (consider domestic v)
Infection
Older age (>35 years)
Narcotic use
What are the clinical features of placental abruption?
Woody hard uterus
Sudden and severe abdominal pain
Vaginal bleeding
What Foetal presentation might there be in placental abruption?
Reduced fetal movements
What might you see on a CTG in placental abruption?
Absent or distressed fetal heart
What might occur disproportionate to the vaginal bleeding in placental abruption?
Hypovolaemic shock
What is the management if the fetus is alive, in distress and less than 36 weeks?
Immediate caesarean section
What is the management if the fetus is alive, not in distress and less than 36 weeks?
Observe closely
Steroids
No tocolysis
What is the management if the fetus is alive, distressed and more than 36 weeks?
Immediate caesarean section
What is the management if the fetus is alive, not distressed and more than 36 weeks?
Vaginal delivery
What is the management if the fetus is dead?
Induce vaginal delivery
What are maternal complications of placental abruption?
Shock
Disseminated intravascular coagulation (DIC)
Post partum haemorrhage (PPH)
what are fetal complications of placental abruption?
Hypoxia
Death
Intrauterine growth restriction
