ABRUPTIO PLACENTAE

Jeannet E. Canda, RN
NDDU
College of Nursing
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.