SAN PABLO COLLEGES

COLLEGE OF NURSING
Brgy. San Rafael San Pablo City, Laguna
4000

ABRUPTIO PLACENTA
CASE STUDY

Presented By:
Catipon, Kyla Loraine L.

Presented To:
Prof. Cecille Lara

BSN LEVEL 2A

May 28, 2024

I. DEFINITION OF DISEASE/CLINICAL SITUATION (f2f)

A. Placenta Abruption

Placental abruption (or abruptio placentae) is the early separation of the typically implanted
placenta after the 20th week of gestation but before the third stage of labor. It is a potentially
dangerous pregnancy condition and a leading cause of third-trimester bleeding/antepartum
hemorrhage.

B. Two types of Placenta Abruption:

● Concealed hemorrhage- the bleeding remains within the uterus, and typically forms a
clot retroplacentally. This bleeding is not visible but can be severe enough to cause
systemic shock.
● Revealed hemorrhage- bleeding tracks down from the site of placental separation and
drains through the cervix. This results in vaginal bleeding.

Modifiable Factors:

● placental abruption in a prior pregnancy

● maternal age over 35 years
● Hypertension
● Smoking

Non-Modifiable Factors:

● Age
● Gender
● Multiple pregnancies

Signs and Symptoms:

● Abdominal pain
● Vaginal bleeding
● Uterine contractions that are longer and more intense than average labor contractions.
● Uterine Tenderness
● Backache/backpain
● Decreased fetal movement

Complications:
● Hemorrhage
● Preeclampsia
● Fetal distress
● Maternal mortality
II. Nursing Considerations

Assessment:

● Monitor fetal heart rate: Continuously monitor fetal heart rate to detect any signs of
fetal distress.
● Assess maternal vital signs: Monitor maternal vital signs, including blood pressure,
pulse, and respiratory rate, to detect any signs of hemorrhage or shock.
● Evaluate fetal movement: Monitor fetal movement to detect any signs of decreased fetal
movement.
● Assess uterine contractions: Assess uterine contractions to detect any signs of preterm
labor or uterine tetany.

Interventions:

● Monitor for signs of hemorrhage: Monitor for signs of hemorrhage, such as vaginal
bleeding, decreased urine output, and tachycardia.
● Administer oxygen: Administer oxygen as needed to support maternal and fetal
oxygenation.
● Manage pain: Manage pain with medications and other interventions as needed to
promote maternal comfort and relaxation.
● Provide emotional support: Provide emotional support and reassurance to the mother
and her family during this stressful and potentially traumatic event.

Education:

● Educate on fetal monitoring: Educate the mother and her family on the importance of
fetal monitoring and the signs and symptoms of fetal distress.
● Educate on postpartum care: Educate the mother on postpartum care, including wound
care, breastfeeding support, and pain management.
● Educate on future pregnancy planning: Educate the mother on future pregnancy
planning, including the importance of prenatal care and monitoring during subsequent
pregnancies.

III. Treatment

1. Hospitalization - Most instances of placental abruption require admission to a hospital to

ensure close monitoring of both the mother and the baby's well-being.

2. Fluids and Blood Transfusions - In cases where significant bleeding occurs due to placental

abruption, healthcare providers may administer intravenous (IV) fluids and blood transfusions to

replace lost blood, ensuring an adequate blood volume and oxygen supply for the baby.
3. Bed Rest - Depending on the severity of the abruption, bed rest might be recommended to

reduce the risk of further bleeding and promote potential healing of the placenta.

4. Medications - Healthcare professionals may prescribe medications to halt uterine contractions

if they are present, as contractions can exacerbate placental abruption. Medications may also be

given to prevent infections or manage pain.

5. Continuous Monitoring - It is essential to continuously monitor the baby's well-being, often

through methods like electronic fetal monitoring, which tracks the baby's heart rate and uterine

contractions.

6. Delivery - In severe instances of placental abruption or when the baby is in distress, an

emergency cesarean section (C-section) may be required for a prompt delivery. The decision to

proceed with delivery depends on factors like the baby's gestational age, the extent of the

abruption, and the mother's overall condition.

IV. Nursing Care Plan
SAN PABLO COLLEGES
COLLEGE OF NURSING
Nursing Diagnosis: Risk for Maternal/Fetal Injury related to Placental Abruption as evidenced by bleeding during preterm labor.

Patient’s Name:_______________________
ASSESSMENT PLANNING/GOAL IMPLEMENTATION RATIONALE EVALUATION GOAL MET
Desired Outcome Independent/dependent Reason for the Expected Outcome
Nursing intervention intervention
Pertinent Data: Patient will: Nurse will: Why: Positive result Yes No
Subjective:
 lower abdominal SHORT TERM GOAL: 1. Monitor vital signs 1. Ensures patient safety SHORT TERM GOAL:
discomforts  Stabilize the 2. Monitor blood pressure 2. Maintains maternal-fetal  The patient patient’s
 vaginal bleeding patient's condition: 3. Monitor fetal heart rate
stability condition was /
 back pain Monitor vital signs, stabilized.
blood pressure, and 3. Enhances patient comfort
 pain scale of 8/10
fetal heart rate; and satisfaction
Objective: administer oxygen
 Abdominal and medications as
guarding needed.
 Muscle Tension LONG TERM GOAL: LONG TERM GOAL:
 Irritability  Prevent further 1. Monitor the patient's 1. Prevents further /
maternal vital signs and physical  Further maternal
complication
complications: assessment for signs of complications was
VITAL SIGNS: Provide supportive 2. Reduces risk of adverse prevented.
infection, such as fever,
 BP: 140/90 care to prevent chills, or increased pulse outcomes
mmhg infection, rate.
 Temp: 36.8 °C hemorrhage, and 2. Monitor the patient's
 RR: 52 bpm other vaginal bleeding and
 PR: 105 bpm complications. report any changes to
the healthcare provider.
PATHOPHYSIOLOGY