Abruptio Placentae and Disseminated Intravascular Coagulopathy
Date
2009
Authors
Hall D.R.
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Abstract
Abruptio placentae is an important cause of vaginal bleeding in the latter half of pregnancy. The key factor in the pathophysiology is hemorrhage at the decidual-placental interface. Small episodes may escape clinical detection, but severe grades impact significantly on fetal and maternal morbidity and mortality, with the most frequent complications being fetal death, severe maternal shock, disseminated intravascular coagulopathy, and renal failure. Important risk factors for the development of abruptio placentae are previous abruption, hypertensive diseases, abdominal trauma, growth restriction, and smoking. The diagnosis is essentially made on the clinical picture that includes vaginal bleeding (usually dark blood), abdominal pain, and uterine contractions. The essence of management is restoration of circulating volume followed by delivery of the fetus and placenta, most often by cesarean section when the diagnosis is clear and the fetus alive and viable. Aggressive resuscitation and expeditious vaginal delivery are the goals when the fetus is dead. © 2009 Elsevier Inc. All rights reserved.
Description
Keywords
fibrinogen, fresh frozen plasma, rhesus D antibody, abdominal injury, abdominal pain, cesarean section, disseminated intravascular clotting, fetal well being, hemorrhagic shock, human, intrauterine growth retardation, maternal hypertension, maternal morbidity, maternal mortality, maternal smoking, pathophysiology, priority journal, resuscitation, review, rhesus isoimmunization, risk assessment, solutio placentae, tocolysis, uterus contraction, vagina bleeding, vaginal delivery, Abruptio Placentae, Disseminated Intravascular Coagulation, Female, Humans, Pregnancy, Risk Factors, Shock, Hemorrhagic
Citation
Seminars in Perinatology
33
3
33
3