gynecology and obstetrics
Placental Abruption (Abruptio Placentae)
Key Points
Placental abruption is premature separation of the placenta from the uterus and can be an obstetric emergency. It typically manifests as uterine bleeding and uterine pain or tenderness; bleeding varies in volume and acuity and, if the abruption is concealed, may be absent. Diagnose based on characteristic symptoms and signs. Ultrasonography can show some cases of abruption; results of abnormal coagulation blood tests or fetal heart rate monitoring support the diagnosis. Manage with prompt cesarean delivery if maternal or fetal stability is threatened or if pregnancy is at term. Consider vaginal delivery if mother and fetus are stable and pregnancy is at term. 