Placental abruption: Difference between revisions
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*Usually occurs spontaneously but also associated w/ trauma (even minor trauma) | *Usually occurs spontaneously but also associated w/ trauma (even minor trauma) | ||
*Must be considered in pts who p/w painful vaginal bleeding near term | *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== | ==Risk Factors== | ||
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#History of C-section or other uterine sx | #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== | ==Work-Up== | ||
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==Treatment== | ==Treatment== | ||
#Fluid resuscitation | #Fluid resuscitation | ||
# | #Transfuse blood products (as needed) | ||
#Emergent OB/GYN consult | #Emergent OB/GYN consult | ||
##If unavailable consider C-section in ED | ##If unavailable consider C-section in ED |
Revision as of 17:56, 1 November 2012
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