Placental abruption, a premature separation of a normally implanted placenta, can be life-threatening for both the mother and baby, with serious complications including shock, organ failure, restricted growth, and premature birth. The document outlines various causes and types, stages, clinical presentation, and management strategies for different scenarios of placental abruption. Diagnosis involves monitoring fetal heart rates, ultrasound, and laboratory tests, while treatment varies based on the timing and condition of both mother and fetus.

1. PLACENTAL
ABRUPTION

2. DEFINITION
• Placental Abruption “Abruptio
placenta” is a premature
separation of a normally
implanted placenta. Source – Tommy’s:

3. ETIOLOGY
• Maternal Hypertension
• Cocaine
• Smokers
• Elderly women (>35 yrs)
• Multiparour
• Previous Abruption
• Thrombophilas
• Twin pregnancy
• PROM
Source – Highmark blue shield (ADAM)

4. TYPES OF PLACENTA
ABRUPTION

5. COMPLICATION
Placental abruption cause life-threatening problems for
both mother and baby.
For the mother, placental abruption can lead to:
1. Shock due to blood loss
2. Blood clotting problems
3. The need for a blood transfusion
4. Failure of the kidneys or other organs resulting from
blood loss
5. Rarly, the need for hysterectomy, if uterine bleeding
can’t be controlled
For the baby, placental abruption can lead to:
1. Restricted growth from not getting enough nutrients
2. Not getting enough oxygen
3. Premature birth

6. SHER CLASSIFICATION
STAGE - 1/TYPE
-1
1. Blood seen only after
delivery
2. Pt. Stable
3. Fetal heart rate normal
4. Uterus contract
notmally
STAGE – 2/TYPE
- 2
1.Blood seen during
labour
2.Uterine tetany
3.Fetal heart rate →
Normal
STAGE – 3/TYPE
- 3
1. Before delivery
bleeding start
2. Most severe
3. Uterine tetany,
bleeding
4. Fetal distress, death
of fetus

7. CLINICAL PRESENTATION
Vaginal bleeding
Uterine Contraction
Abdominal and / or back pain

8. DIAGNOSIS
• Fetal heart rate
monitoring: • Ultrasound
• Laboratory tests:

9. MANAGEMENT/TREATMENT OF
ABRUPTION
Condition - 1
Abruption at term(>37 week)
• If baby stable
• Mother is stable→ No C-Section → Only C-Section when
fetal distress occur
↓
← So normal delivery as fast as poss
If pt. With Abruption
Artificial rupture of membrane

10. CONDITION -2
Abruption at 32 weeks{Lung is not mature}
1. Resuscitation
2. Steroid
3. Sedation, rest
Blood clot
↓
Tissue thromboplastin
↓
Enter in circulation
↓
Trigger extrinsic coagulation
Cascade
↓
Coagulopathy
↓
DIC
↓
Death
So don’t conserve, because it is Abrupti
↓
Then Artificial rupture of membrane
+
Steroid

11. THANKS