Abruptio Placentae

Ryan J. Callery, MD Reviewed 06/2017
 


BASICS

DESCRIPTION

Premature separation of an otherwise normally implanted placenta due to bleeding at the decidual-placental interface 

EPIDEMIOLOGY

INCIDENCE

  • 0.3–1% of pregnancies are complicated by pla...

DIAGNOSIS

HISTORY

  • Classic triad of vaginal bleeding, abdominal pain, and contractions

  • Abruption in prior pregnancy

  • Early trimester bleeding

  • Recent trauma

  • Cocaine or tobacco use

  • Back pain

  • Frequent or tetanic ...

TREATMENT

MEDICATION

FIRST LINE

  • Tocolytics are generally contraindicated in presence of abruption (7)[B]

ONGOING CARE

FOLLOWUP RECOMMENDATIONS

  • Monthly growth ultrasonograms for those patients where conservative management is possible (11)[C]

  • Serial ultrasounds may also be used to follow regression or progr...

REFERENCES

Ananth CV, Keyes KM, Hamilton A et al. An international contrast of rates of placental abruption: an age-period-cohort analysis.PLoS One.  2015;10(5):e0125246. [View Abstract on OvidI...

ADDITIONAL READING

  • Getahun D, Ananth CV, Peltier MR et al. Acute and chronic respiratory diseases in pregnancy: associations with placental abruption. Am J Obstet Gynecol.  2006;195(4):1180–1184....

CODES

ICD10

  • O45.90 Premature separation of placenta, unsp, unsp trimester

  • O45.8X9 Other premature separation of placenta, unsp trimester

  • O45.029 Prem separtn of placenta w dissem intravasc coag, unsp tri

  • ...

PEARLS

  • Placental abruption is the most common cause of serious vaginal bleeding in late pregnancy.

  • Abruption is a clinical diagnosis. The classic triad is vaginal bleeding, abdominal pain, and contract...

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