Abruptio placentae

One obstetric example of such complications is Abruptio placentae (placental abruption). It is a medical condition characterized by the displacement, either partially or fully, of the placenta against the inner uterine wall. Abruptio placentae is uncommon; however, it posts such great risks to the mother and fetus. It occurs unexpectedly, oftentimes needing immediate medical intervention for it endangers the mother and her unborn child. Signs and Symptoms of Placental Abruption Abruptio placentae usually occurs at the third trimester or a few weeks before giving birth. The classic triad of the clinical manifestation of Abruptio placentae are: • Vaginal bleeding – varies in amount and is present in 80% of patients diagnosed of placental abruptions; the remaining 20% are those with concealed hemorrhages • Abdominal/uterine tenderness or rigidity and back pain – occurs suddenly; sometimes severe • Abnormal uterine contractions – completes the triad of Abruptio placentae; usually continuous in nature, one contraction coming after another It is important to note that the absence of vaginal bleeding does not rule out the diagnosis of Abruptio Placentae. • History of abruptio placentae that is not cause by traumatic abdominal injury • Chronic • Hypertension-related problems during preeclampsia, eclampsia, HELLP syndrome (which stands for Hemolysis, Elevated liver enzymes and Low Platelet levels) • Abdominal trauma – usually due to fall • Smoking • Drug abuse during • Early ruptur...

Bleeding may occur at various times in pregnancy. Although bleeding is alarming, it may or may not be a serious complication. The time of bleeding in the pregnancy, the amount, and whether or not there is pain may vary depending on the cause. Bleeding in the first trimester of pregnancy is quite common and may be due to the following: • Miscarriage (pregnancy loss) • Ectopic pregnancy (pregnancy in the fallopian tube) • Gestational trophoblastic disease (a rare condition that may be cancerous in which a grape-like mass of fetal and placental tissues develops) • Implantation of the placenta in the uterus • Infection • Bleeding between the uterine wall and placental membrane (subchorionic hemorrhage or hematoma) • Normal changes in the cells of the cervix due to pregnancy Bleeding in late pregnancy (after about 20 weeks) may be due to the following: • Placenta previa (placenta is near or covers the cervical opening) • Placental abruption (placenta detaches prematurely from the uterus) • Unknown cause Placenta previa is a condition in which the placenta is attached close to or covering the cervix (opening of the uterus). Placenta previa occurs in about one in every 200 live births. There are three types of placenta previa: • Total placenta previa. The placenta completely covers the cervix. • Partial placenta previa. The placenta is partially over the cervix. • Marginal placenta previa. The placenta is near the edge of the cervix. What causes placenta previa? The cause of plac...

Article: • • • • • • • • Images: • • Epidemiology The estimated incidence is ~1% of all pregnancies. The rate of placental abruption is thought to have dramatically increased in the past few years. Risk factors A number of risk factors have been associated with placental abruption, including: • • previous placental abruption (recurrence rate 19-25%) 11 • • maternal age: pregnant women who are younger than 20 years or older than 35 years are at greater risk • • cigarette smoking • cocaine or other amphetamine use • • • • multiparity • Clinical presentation Patients typically present with painful vaginal bleeding with "board-like" abdominal tone. Bleeding can occasionally be 'concealed' as in a Other features include: • uterine contractions and irritability • lumbar pain • maternal/ fetal compromise secondary to exsanguination Pathology The exact etiology is unknown, but the final pathophysiology is likely to rupture of a spiral artery with hemorrhage into the decidua basalis leading to separation of the placenta. The small vessel disease seen in abruptio placentae may also result in According to the position of the abruption within the placenta it can be classified as: • • • Radiographic features Ultrasound Ultrasound is almost always the first (and usually the only) imaging modality used to evaluate placental abruption, but an index of suspicion should be maintained for the diagnosis since ultrasound is relatively insensitive for the diagnosis 9. This is partly because a T...

Placental abruption is a condition during pregnancy when the placenta separates from the uterus. Symptoms can include bleeding and abdominal pain, especially during the third trimester. A healthcare provider will diagnose and treat a placental abruption based on the severity of the separation and gestational age of the fetus. Overview What is a placental abruption? Placental abruption is a complication of pregnancy that happens when the placenta separates from your uterus before delivery. The placenta is a temporary organ that connects a growing fetus to your uterus during pregnancy. It attaches to the wall of your uterus, usually on the top or side and acts as a lifeline that gives nutrients and oxygen to the fetus through the In placental abruption, the placenta may completely detach or partially detach. This can decrease the amount of oxygen and nutrients to the fetus and cause heavy bleeding in the birthing parent. Placental abruption is a serious condition that requires medical treatment. What are the different types of placental abruption? • A partial placental abruption occurs when the placenta does not completely detach from the uterine wall. • A complete or total placental abruption occurs when the placenta completely detaches from the uterine wall. There is usually more vaginal bleeding associated with this type of abruption. • Revealed placental abruptions have moderate to severe vaginal bleeding that you can see. • Concealed placental abruptions have little or ...

What Is Abruptio Placentae? Abruptio placentae, also called premature separation of the placenta, is a serious complication of pregnancy. The placenta peels away from the inner wall of the uterus before delivery. It can be subdivided into 3 types known as grades I, II, and III, which range from mild to severe. A placenta that separates from the uterine wall cannot be reattached. Untreated abruption can harm both mother and baby. It can mean too little oxygen and nutrients for the baby and heavy bleeding in the mother. Complications are related to cesarean delivery, bleeding, and prematurity. It’s a medical emergency. What Causes Abruptio Placentae? The cause is unknown, but it’s not inherited. Risk factors include hypertension, trauma, and multiple pregnancies. Abnormalities of pregnancy called chorioamnionitis and polyhydramnios are also risk factors. Others are age (younger than 20 and older than 35), preeclampsia, diabetes, smoking, use of cocaine, and having more than 14 alcoholic drinks per week during pregnancy. What Are the Symptoms of Abruptio Placentae? The main symptoms are uterine bleeding, abnormal uterine contractions, and fetal distress as based on laboratory tests and checking the fetal heart. Contractions are painful and obvious. Weakness, low blood pressure, fast heart rate, abdominal pain, and back pain may occur. Grade 1 abruption includes mild bleeding from the vagina and uterine contractions, stable vital signs, and stable fetal heart rate. The laborat...

Tocolysis is considered controversial in the management of placental abruption and is considered only in patients (1) who are hemodynamically stable, (2) in whom no evidence of fetal jeopardy exists, and (3) in whom a preterm fetus may benefit from corticosteroids or delay of delivery. Even in patients meeting these criteria, consultation with an MFM specialist is important. Tocolysis must be undertaken with caution, because maternal or fetal distress can develop rapidly. In general, either magnesium sulfate or nifedipine (but not both) is used for tocolysis and beta-sympathomimetic agents are avoided, as the latter may cause significant undesirable cardiovascular effects, such as tachycardia, which may mask clinical signs of blood loss in these patients. Class Summary Corticosteroids are given when preterm delivery (less than 37 weeks) is expected.They are associated with a decreased risk of neonatal respiratory distress, necrotizing enterocolitis, and intracranial hemorrhage.The two most used medications are betamethasone and dexamethasone.While they should be considered if the patient is preterm with an abruption, delivery should not be delayed for their administration. • Abu-Heija A, al-Chalabi H, el-Iloubani N. Abruptio placentae: risk factors and perinatal outcome. J Obstet Gynaecol Res. 1998 Apr. 24(2):141-4. • Oyelese Y, Ananth CV. Placental abruption. Obstet Gynecol. 2006 Oct. 108(4):1005-16. • Workalemahu T, Enquobahrie DA, Gelaye B, Thornton TA, Tekola-Ayele F, ...