gynecology and obstetrics
Placental Abruption (Abruptio Placentae)
Introduction
Placental abruption (abruptio placentae) is premature separation of the placenta from the uterus, usually after 20 weeks gestation. It can be an obstetric emergency. Manifestations may include uterine pain and tenderness and vaginal bleeding, possibly with hemorrhagic shock and disseminated intravascular coagulation. The source of bleeding in placental abruption is maternal. Diagnosis is clinical and sometimes by ultrasonography. Treatment is prompt delivery for maternal or fetal instability or a near-term pregnancy. Placental abruption and other obstetric abnormalities increase the risk of morbidity or mortality for the woman, fetus, or neonate. Placental abruption occurs in 0.4 to 1.5% of all pregnancies; incidence peaks at 24 to 26 weeks gestation. Placental abruption may involve any degree of placental separation, from a few millimeters to complete detachment. Separation can be acute or chronic. Separation results in bleeding into the decidua basalis behind the placenta (retroplacentally). Most often, etiology is unknown. 