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Abruptio Placentae

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Topic updated on 01/28/16 10:33pm

Snap Shot
  • A 24-year-old G1P0 female at 30 weeks gestation presents with vaginal bleeding and painful contractions. Physical examination reveals a firm, tender uterus.
Introduction
  • Abrupt ("abruptio") premature detachment of placenta from implantation site as a result of retroplacental hemorrhage
  • Risk factors
    • smoking
    • hypertension
    • cocaine use
    • advanced maternal age
    • chorioamnionitis
    • trauma
Presentation
  • Symptoms
    • painful bleeding in 3rd trimester
      • may be concealed
    • preterm labor
  • Physical exam
    • do NOT perform pelvic examination if suspected
Evaluation
  • Ultrasound
Treatment
  • Conservative
    • delivery
  • Pharmacologic
    • maintain maternal blood pressure if hemorrhaging
Complications
  • High risk of fetal mortality
  • Maternal DIC

 



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