Non Modifiable Modifiable

 Traumatic injury
 Smoking
 PIH
 PROM  Use of cocaine
 Increase maternal age (30 yrs above)  Multiple gestation
 History of abruptio placenta  Malnutrition
 Socio-economic
 Race
 Fibroids

Decrease resiliency of blood vessels at placental bed

torn or ruptured vessels

partial separation (grade 1 and 2) total separation (grade 3)

massive vaginal or conceived hemorrhage

peripheral portion is detached central portion is detached

(mild to moderate concealed bleeding) dec. platelet Fetal Death -uterine tetany
dec. fibrinogen (100%) -board like
mild to moderate vaginal bleeding blood is trapped to intact peripheral portions inc. fibrin rigidity
degradation -
abdominal/back
pain
fluid enters muscle fibers DIC -inc. abdominal
girth

Increased uterine wall irritability

FHT may be reassuring uterus turns to blue or purple utero placental apoplexy

If progressive separation

maternal shock (100%)

Uterine tetany fetal distress decrease BP
(decreased variability) (late lacerations) increase PR

50% separation
severe fetal distress

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