Placental Abruption Flashcards
1
Q
What is placental abruption?
A
Detachment of the placenta from the uterine wall prior to the 3rd stage
2
Q
What are some risk factors for PA?
A
- Chronic HTN, pre-eclampsia, thrombophilia, previous placental abruption, smoking, cocaine use
- Chorioamnionitis
- Sudden reduction in size of an over-distended uterus
○ Rupture of membranes associated with polyhydramnios, between births of multiple pregnancies - Trauma
3
Q
How does PA present?
A
Vaginal bleeding (though not always as it can be contained by the placenta)
Abdominal pain
Back pain
Fetal demise
4
Q
How is PA managed?
A
- IV access
- FBE, coag screen
- Kleihauer-Betke or flow cytometry to assesss feto-maternal transfusion
- Monitor vital signs
- Continuous CTG
- Anti-D
- Corticosteroids for fetal lung maturation if
5
Q
When do you delivery in PA?
A
Consider
- Timing - if after 37 weeks then delivery
- If before consider the haemodynamic state of the mother and fetus
6
Q
How do you deliver PA babies?
A
If unstable - C-section
If stable or dead fetus - vaginal
7
Q
How is PA diagnosed?
A
Clinical diagnosis
Only 2% picked up on US
