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What Is Placental Abruption?
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Also known as abruptio placentae, placental abruption is the partial or complete “abrupt” separation of the placenta from the uterus before delivery. Its incidence is about 1%. It is mostly commonly caused by blunt abdominal trauma or maternal hypertension.
Clinical Presentation and Diagnosis of Placental Abruption
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Symptoms are like those of other pregnancy complications—vaginal bleeding, abdominal pain, and uterine contractions. Like placenta previa, placental abruption is a common cause of significant third-trimester bleeding; however, abruption is typically associated with abdominal pain and tenderness as compared with the painless bleeding from placenta previa. Disseminated intravascular coagulation (DIC) can be seen with complete placental abruption.
Abruption is diagnosed based on the clinical signs and symptoms as noted. It is not always visible on a transabdominal ultrasonography.
Treatment of Placental Abruption
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If the placenta completely separates from the uterine wall, prompt treatment and stabilization of the patient and delivery of the neonate are necessary. In some cases, it may be possible to manage partial placental abruption without delivery. Abruption has a high risk of fatality for both the patient and the fetus, given the potential for massive maternal hemorrhage and the loss of fetal perfusion and oxygenation.
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