Placental Abruption Flashcards
What is placental abruption?
Placental abruption is the premature separation of the placenta from the uterine wall before delivery of the fetus.
How is placental abruption classified?
It is classified as partial (part of the placenta separates) or complete (entire placenta separates).
What are the risk factors for placental abruption?
Risk factors include maternal hypertension, trauma, smoking, cocaine use, previous abruption, multiple pregnancies, and advanced maternal age.
What are the typical symptoms of placental abruption?
Symptoms include sudden onset of vaginal bleeding, abdominal pain, uterine tenderness, and, in severe cases, signs of maternal shock.
How does placental abruption present on examination?
Findings may include a tender, rigid uterus, signs of hypovolaemia, and fetal distress or absent fetal heart tones if severe.
How is placental abruption diagnosed?
Diagnosis is primarily clinical, supported by ultrasound and blood tests to assess maternal and fetal status.
What is the most common complication of placental abruption for the fetus?
The most common complication is fetal hypoxia, which can lead to stillbirth if untreated.
What are the complications of placental abruption for the mother?
Complications include haemorrhagic shock, disseminated intravascular coagulation (DIC), postpartum haemorrhage, and maternal death.
What investigations are used in suspected placental abruption?
Investigations include ultrasound, full blood count (FBC), coagulation profile, group and save, and fetal monitoring via CTG.
What role does ultrasound play in placental abruption?
Ultrasound can help identify retroplacental haematoma but may not detect all cases; clinical assessment is critical.
What are the grades of placental abruption severity?
Grades include mild (minimal bleeding, no fetal distress), moderate (some fetal distress), and severe (significant bleeding, fetal death).
How is mild placental abruption managed?
Mild cases may be managed conservatively with close monitoring of the mother and fetus, ensuring haemodynamic stability.
How is severe placental abruption managed?
Severe cases require immediate resuscitation, maternal stabilisation, and expedited delivery, often via caesarean section.
What is the role of corticosteroids in placental abruption?
Corticosteroids are given if delivery is anticipated preterm to promote fetal lung maturity.
When is vaginal delivery considered in placental abruption?
Vaginal delivery may be considered if the fetus is dead, the mother is stable, and labour is progressing quickly.
What is the prognosis for placental abruption?
Prognosis depends on the severity of the abruption, gestational age, and timeliness of management; severe cases carry high maternal and fetal risks.
What is concealed placental abruption?
Concealed abruption occurs when blood is trapped behind the placenta, leading to minimal or no vaginal bleeding but significant maternal and fetal compromise.
How does trauma cause placental abruption?
Trauma, such as a fall or car accident, can disrupt the placental attachment, leading to abruption.
What are the long-term risks for women after placental abruption?
Risks include recurrence in future pregnancies, preterm delivery, and an increased risk of hypertensive disorders.
What is disseminated intravascular coagulation (DIC) in the context of placental abruption?
DIC is a severe complication where widespread clotting and bleeding occur due to release of procoagulant substances from the abruption.
How is haemorrhagic shock managed in placental abruption?
Management includes aggressive IV fluid resuscitation, blood transfusion, and treatment of the underlying cause of bleeding.
What are the differential diagnoses for placental abruption?
Differential diagnoses include placenta praevia, uterine rupture, vasa praevia, and preterm labour.
How does smoking increase the risk of placental abruption?
Smoking impairs placental function and blood flow, increasing the likelihood of abruption.
What is the role of CTG in placental abruption?
CTG (cardiotocography) is used to monitor fetal heart rate patterns for signs of distress.
What lifestyle changes can reduce the risk of placental abruption?
Smoking cessation, avoiding cocaine or other drugs, and managing hypertension can reduce the risk.
What are the psychological impacts of placental abruption on the mother?
Women may experience anxiety, grief, or post-traumatic stress due to the complications and outcomes of abruption.
