Placental Abruption

Question 1

What are the 3 types of placental abruption?

Answer 1

Revealed
Concealed
Mixed

Question 2

What is a revealed placental abruption?

Answer 2

External bleeding present

Question 3

What is a concealed placental abruption?

Answer 3

Blood is contained by the placenta and uterine wall so doesn’t present with bleeding

Question 4

What are the risk factors associated with the current pregnancy?

Answer 4

Pre-eclampsia
Polyhydramnios
Multiple pregnancy

Question 5

What are the risk factors associated with previous pregnancies?

Answer 5

Previous abruption
Increasing parity
Cocaine ABUSE

Question 6

What are other risk factors of placental abruption?

Answer 6

Chronic hypertension
Smoking
Cocaine use

Question 7

Typical history

Answer 7

” 42 y/o smoker presents with preterm labour at 28 weeks. She has abdominal pain that is getting worse. She has also had some vaginal bleeding and examination reveals a woody abdomen. “

Question 8

When is most common time for placental abruption to occur?

Answer 8

28 weeks

Question 9

What investigations should be done for the mother?

Answer 9

Bloods

USS - may not be useful

Question 10

What bloods should be done?

Answer 10

Hb
Haematorcrit
Clotting screen

Question 11

What should be done constantly for the foetus?

Answer 11

CTG

Question 12

Initial treatment of a suspected placental abruption?

Answer 12

Stabilisation

Anti D antibodies

Delivery

Question 13

What delivery method should be used and when?

Answer 13

Vaginal

• If good CTG and mother stable
• Induced by syncontin

C section
- Poor CTG

Question 14

What is the big complication of placental abruption?

Answer 14

Shock

DIC

Question 15

Treatment for DIC?

Answer 15

FFP

Cryoprecipitate

Question 16

What should be done post surgically if the bleeding doesn’t stop?

Answer 16

Ligation of uterine artery