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Abruptio Placentae: Lin Qi de
Abruptio Placentae: Lin Qi de
Lin Qi De
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
diagnosis
Classic clinical presentation:
vaginal bleeding Tender uterus Uterine contractions Fetal distress
Coagulation abnormalities
Hypofibrinogenemia
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
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.