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Placental Abruption
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
The diagnosis of placental abruption is primarily clinical. History, physical exam, laboratory tests, and ultrasonographic studies guide management. Ultrasound is primarily useful in ruling out other causes of third-trimester bleeding.
Placenta previa and placental abruption
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Placental abruption is defined as separation of the placenta from the maternal endometrium that occurs before birth. This leads to bleeding at the site of separation from local maternal blood vessels. Most often, the maternal blood then tracks downward between the fetal membranes and uterine wall and comes out of the cervix. If this bleeding remains trapped behind the placenta and is not clinically evident, then the abruption is “concealed.” This occurs in approximately 10% of cases. This placental separation may occur secondary to an acute process, such as maternal trauma, or from a chronic process, such as maternal smoking.
Antepartum Haemorrhage
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Placental abruption is defined as the partial or complete separation of a normally situated placenta before the delivery of the fetus. Although the incidence of placental abruption has decreased over the years to approximately 1 in 100 pregnancies at the present time, it continues to be a major contributor to maternal mortality, severe acute maternal morbidity and perinatal mortality and morbidity. The maternal effects depend primarily on its severity, while the fetal outcome depends on its acuteness as well as the gestational age when it occurs.
Determinants of low birth weight among newborns delivered in China: a prospective nested case-control study in a mother and infant cohort
Published in Journal of Obstetrics and Gynaecology, 2023
Zhuomin Huang, Quanfu Zhang, Litong Zhu, Haishan Xiang, Depeng Zhao, Jilong Yao
In the present study, a correlation was found between placental abruption and both LBW and full-term LBW. To the best of our knowledge, placental abruption is a major cause of neonatal outcomes such as perinatal asphyxia, stillbirth, prematurity, and maternal complications including risk for haemorrhage, disseminated intravascular coagulation, and even death (Schmidt et al.2022). However, few studies have focussed on placental abruption and LBW directly. Mavedatnia et al. (Mavedatnia et al.2021) found no direct interaction between birthweight and placental abruption but concluded that prematurity and birthweight were the main mediators of lower Apgar scores and intensive care admission (Kramer et al.1997). Moreover, pregnancy-induced hypertension is regarded as an important risk factor for placental abruption (Kramer et al.1997, Khan et al.2022). Placental calcification leads to preeclampsia, which eventually accounts for decreased uteroplacental blood flow and LBW (Khan et al.2022, Dash et al.2021).
Umbilical artery ultrasound haemodynamics combined with serum adiponectin levels can aid in predicting adverse pregnancy outcomes in patients with severe pre-eclampsia
Published in Journal of Obstetrics and Gynaecology, 2023
Zhi Zhang, Fei Liu, Qiling Zhang, Danya Li, Liping Cai
In the present study, adverse pregnancy outcomes were defined as maternal primary postpartum haemorrhage and placental abruption, neonatal asphyxia, low birth weight, foetal distress, and foetal growth restriction (FGR) (Gottardi et al.2021, Takahashi et al.2018). Specifically, placental abruption refers to uterine bleeding greater than usual in the absence of placenta previa or trauma (related to contractions, non-reassuring foetal heart tones and/or clinical diagnosis of abruption) resulting in delivery (Tita et al. 2022). FGR represents a birth weight measuring under the 10th percentile for gestational age and infant sex according to the Duryea population standard and a small-for-gestational-age birth weight measuring under the 5th percentile (Duryea et al.2014, Tita et al.2022). Hence, this study recruited 118 sPE patients and 90 normal pregnant women and collected their clinical information and blood samples to analyse the expression of Sad and its correlation with Doppler parameters, in anticipation of predicting pregnancy outcomes in sPE patients.
The Association between Placental Abruption and Platelet Indices
Published in Fetal and Pediatric Pathology, 2023
Duygu Tugrul Ersak, Özgür Kara, Kadriye Yakut, Aytekin Tokmak, Cem Yaşar Sanhal, Aykan Yücel, Dilek Şahin
Placental abruption (PA) is an obstetric disaster with a frequency varying between 0.4% and 1%. In abruption, the placenta is separated from the uterus while the second stage of labor has not yet been completed. Bleeding may lead to fetal ischemia and hypoxia and is of maternal origin [1,2]. The diagnosis of placental abruption is clinical [3]. PA manifests classically by vaginal bleeding, abdominopelvic pain, maternal tachycardia or hypotension, prolonged fetal bradycardia, and late decelerations on non-stress testing indicating impaired fetal well-being [4]. The life of both the mother and fetus is threatened. Maternal complications of PA depend on the successive process leading to coagulation disorders with hemorrhage followed by hypovolemic shock and death. Fetal complications of PA such as preterm labor, fetal death, intrauterine growth restriction, and neonatal asphyxia was shown to be associated with the gestational age and the severity of separation of the placenta [5,6].