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Abruptio Placentae

Prabhcharan Gill, MD, FRCOG, FACOG Reviewed 06/2019
 


BASICS

DESCRIPTION

Bleeding at the decidua-placental interface. The diagnosis is typically reserved for pregnancies after 20 weeks. 

EPIDEMIOLOGY

Incidence

  • The overall prevalence rate of abruption in Unit...

DIAGNOSIS

HISTORY

  • May present with classic triad of vaginal bleeding, contractions, and abdominal pain or with complaints of discomfort or pain between contractions or contractions observed to be frequ...

TREATMENT

MEDICATION

First Line

  • Tocolytics are generally contraindicated in presence of abruption.

    • Inpatient tocolytics such as nifedipine may be used in nonsevere abruption before 34 weeks (generally ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Fetal growth surveillance with interval obstetric ultrasound

  • Correction of maternal anemia

  • Patient self-surveillance for symptoms of recurrent abruption

  • Elective del...

REFERENCES

1
Sakornbut E, Leeman L, Fontaine P. Late pregnancy bleeding. Am Fam Physician.  2007;75(8):1199–1206. [View Abstract on OvidMedline]
2
de Lloyd L, Bovington R, Kaye A, et al. Standard ha...

ADDITIONAL READING

  • Ozcan T, Pressman EK. Imaging of the placenta. Ultrasound Clin.  2008;3(1):13–22. [View Abstract on OvidMedline]

  • Salihu HM, Bekan B, Aliyu MH, et al. Perinatal mortality associa...

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

  • ...

CLINICAL PEARLS

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

  • Abruption is a clinical diagnosis suggested by vaginal bleeding, abdominal pain, and contract...

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