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ABRUPTIO PLACENTAE

ABRUPTIO PLACENTAE. 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.

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ABRUPTIO PLACENTAE

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  1. ABRUPTIO PLACENTAE Lin Qi De

  2. Definition Abruptio Placentae( placental abruption): premature separation of the normally implanted placenta from the uterine wall.

  3. 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

  4. Classification Complete separation:no vaginal bleeding Partial separation :vaginal bleeding will be apparent Marginal separation : vaginal bleeding will be apparent

  5. diagnosis • Classic clinical presentation: • vaginal bleeding • Tender uterus • Uterine contractions • Fetal distress

  6. Coagulation abnormalities • Hypofibrinogenemia • Increaseing levels of fibrin degradation products • decreasing platelet count • Increasing prothrombin time and partial thromboplastin time • Decreasing other serum clotting factors

  7. 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.

  8. Management • Maintain hemodynamic stabilization (Transfusion therapy) • Crystalloid transfusion • Whole blood therapy • Component therapy • Correct coagulation status

  9. 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.

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