ABRUPTIO PLACENTAE

Definition
Abruptio Placentae( placental
abruption):

premature separation of the

normally implanted placenta from the
uterine wall.
 Etiology
Mechanism: hemorrhage into the decidua
basalis, leading to premature placental
separation and further bleeding.

Associated factors:
•Maternal hypertension
•Sudden decompression of the uterus
•Maternal cocaine use
•trauma
 Classification
Complete separation: no vaginal
bleeding
Partial separation :vaginal bleeding
will be apparent

Marginal separation : vaginal

bleeding will be apparent
 diagnosis
Classic clinical presentation:
•vaginal bleeding

•Tender uterus

•Uterine contractions

•Fetal distress
Coagulation abnormalities
•Hypofibrinogenemia
•Increaseing levels of fibrin degradation
products
•decreasing platelet count
•Increasing prothrombin time and partial
thromboplastin time
•Decreasing other serum clotting factors
Ultrasonography:
relatively large retroplacental clots may
be detected

Placental examination
The extent of placental abruption of the
maternal surface of the placenta on which
a clot is detect at the time of delivery.
 Management
Maintain hemodynamic stabilization
( Transfusion therapy)
•Crystalloid transfusion
•Whole blood therapy
•Component therapy

Correct coagulation status

Delivery
•When the fetus is mature,vaginal delivery
is preferable unless there is evidence of
fetal distress or hemodynamic instability.

•When the fetus is not mature and

placental abruption is limited,observation
with close monitoring of both fetal and
maternal status.