Abruptio placentae

Abruptio placentae

Abruptio placentae

Definition:
it is one form of APH where the bleeding occurs due to premature saperation of normally situated placenta.

Varieties_
1 reveled 2 concealed 3 mixed..

Etiology_
the prevalence is more common with 1 high birth order,advancing age of mother,poor socio economic states,malnutrion,smoking.
Hypertension in pregnancy is most imp factor.Trauma,sudden uterine decompression,short cord,sick placenta,folic acid deficiency,torsion of uterus are associted with.



Pathogenesis_
premature saperation of placenta is intiated by haemorrage into d decidua basalis. Clinical featurs_Reveal type_abdo discomfort or pain followed by vaginal bleeding.Continous dark coloured bleeding.General condn proportionate bleeding.Pallor,uternie ht proportinate to period of gastestion.,fHS present.
Mixed type. Acute intese pain in abdomen,shock is pronounced,sever pallor.Uterine ht disproportionally enlarge and globular.,uterus tense tender.

Management._
prevetion aim at elimination of known factor,correction of anaemia,therapy to minimise comlication.
Treatment-
Revealed type!!If pt is in labore the ARM is done and oxytocin is added if necessacasy.Resucciate the pt.
2 -if pt is nt in labour_>37wk-ARM and oxytocin.
<37wk_if bleeding stop try to continue the pregnancy upto 37 wk.But if bleedinag continue,ARM and oxytocin..
Conceled typeg_bld transfusion,periodic coagulation profile,urine output,fetal monitoring.Then ARM and oxytocine.If there is no response. Or fetal distress cs is done..