placental abruption

Question 1

what is placental abruption

Answer 1

when the placenta separates from the wall of the uterus during pregnancy
significant cause of antepartum haemorrhage

Question 2

associated factors with placental abruption

Answer 2

proteinuric hypertension
cocaine use
multiparity
maternal trauma
increasing maternal age

Question 3

clinical features of placental abruption

Answer 3

shock out of keeping with visible loss
pain constant
tender, tense uterus
normal lie and presentation
fetal heart: absent or distressed
coagulation problems

Question 4

criteria for minor, major and massive haemorrhage

Answer 4

minor: less than 50 ml
major: 50-1000ml
massive: more than 1000

Question 5

initial management of major or massive haemorrhage

Answer 5

get senior
2x grey cannula
bloods: FBC, UE, LFT and coag
crossmatch
fluid and blood resus
CTG monitoring

Question 6

management of placental abruption if fetus is alive and < 36 weeks

Answer 6

fetal distress: immediate caesarean
no fetal distress: observe closely, steroids, no tocolysis, threshold to deliver depends on gestation

Question 7

fetus alive and > 36 weeks

Answer 7

fetal distress: immediate caesarean
no fetal distress: deliver vaginally