Abruptio Placentae

OVERVIEW

Abruptio placentae (placental abruption) is the premature separation (can be either partial or complete) of the placenta from the the uterine wall before the delivery of the infant.

Abruptio placentae can present in a few different ways (with either internal or external bleeding, source).
Abruptio placentae can present in a few different ways (with either internal or external bleeding, source).
WHAT MAKES US SUSPECT IT?

Risk Factors:

Trauma (such as a traffic collision), smoking, hypertension, preeclampsia, cocaine use

Initial Presentation:

  • Abrupt and painful vaginal bleeding bleeding during the in the third trimester.
  • Abdominal/back pain

Physical Exam:

  • Hypertonic/tender uterus
  • Distended uterus (larger then expected fundal height) can be present in patients who have concealed bleeding.

History Of Present Illness:

Blood is often dark red

CLINCIAL WORKUP

Fetal heart monitoring may be remarkable for:

  • Frequent by low amplitude uterine contractions.

Ultrasound is not required for diagnosis (usually made by the clinical presentation) however it is useful in ruling out placenta previa. It can also reveal the presence of a retroplacental hematoma (that will sometimes not cause vaginal bleeding).

This ultrasound study shows the fetus (F), the placenta (P) and a retroplacental abruption (P, source).
This ultrasound study shows the fetus (F), the placenta (P) and a retroplacental abruption (P, source).
HOW SERIOUS IS THIS CONDITION?

This condition is potentially life threatening to both the mother and child.

ARCHIVE OF STANDARDIZED EXAM QUESTIONS

This page organizes example exam questions that ask about abruptio placentae

 

Page Updated: 09.12.2016