Placental Abruption

Question 1

Defintion of Placental Abruption

Answer 1

Premature Separation of a normally sited placenta from uterine wall

Question 2

In 2/3 of abruption cases it is

Answer 2

the edge of the placenta, blood flows into cervix causing vaginal bleeding

Question 3

In 1/3 of cases

Answer 3

uterine pain, maternal shock, fetal distress and fetal death

Question 4

Cause

Answer 4

Unknow but associated w/ 1.defective trophoblastic invasion
2. direct abdominal trauma
3. high parity
4. polyhydramnios
5. sudden decompression of uterus
6. HTN

Question 5

Risk Factors of Placental Abruption

Answer 5

1. HTN
   2.Smoking
2. Trauma of abdomen
3. Cocaine
4. Anticoagulant therapy
5. FGR
   7.Polyhydramnios

Question 6

Clinical presentation of Placental Abruption

Answer 6

Abdominal Pain
Contractions (@ term or close)
Vaginal Bleeding (may/may not be present)

Large Abruptions:
maternal shock +/- collapse

Question 7

Abdominal Palpations

Answer 7

tender tense woody hard uterus
difficult to palpate fetus

Question 8

Effects of Placenta Abruption

Answer 8

1.Hypovolemic shock
2.Disseminated intravascular 3.coagulation
4.Acute renal failure (2ndry to Hypovolemic shock)
5.Fetomaternal haemorrhage (*** esp in Rh - mom)
6.Perinatal mortality
7.FGR

Question 9

Management

Answer 9

If no fetal distress, close monitor and plan delivery