Placental abruption: Difference between revisions
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==Source== | ==Source== | ||
Tintinalli | Tintinalli | ||
==See Also== | |||
[[Vaginal Bleeding (Main)]] | |||
[[Category:OB/GYN]] | [[Category:OB/GYN]] |
Revision as of 06:03, 23 August 2013
Background
- Premature separation of placenta from uterus
- Usually occurs spontaneously but also associated w/ trauma (even minor trauma)
- Must be considered in pts who p/w painful vaginal bleeding near term
- Abruption may be complete, partial, or concealed
- Amount of external bleeding may not correlate with severity
Risk Factors
- HTN
- Trauma
- Smoking
- Advanced maternal age
- Cocaine abuse
- History of C-section or other uterine sx
Clinical Features
- Painful vaginal bleeding
- Severe uterine pain
- Uterine contractions
- Hypotension
- N/V
- Back pain
Work-Up
- Type + Cross
- CBC
- DIC panel
- US
- Sp, not Sn
- Can r/o previa
Treatment
- Fluid resuscitation
- Transfuse blood products (as needed)
- Emergent OB/GYN consult
- If unavailable consider C-section in ED
Complications
- Maternal
- Hemorrhagic shock
- DIC
- Uterine rupture
- Multi-organ failure
- Neonatal
- Neurodevelopmental abnormalities
- Death
Source
Tintinalli