Abruptio Placenta

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ABRUPTIO PLACENTA
 Placenta abruptio is separation of the placenta (the organ that nourishes the fetus) from the site of uterine implantation before delivery of the fetus.
 It affects about 9 out of 1,000 pregnancies. It usually occurs in the third trimester, but it can happen at any time after the 20th week of pregnancy.
CAUSES: Unknown
RISK FACTORS:
a. Maternal hypertension
b. Advance maternal age
c. Grand multiparity
d. Trauma to the uterus
e. Hydramnios
f. Short umbilical cord
g. Cigarette smoking
TYPES OF ABRUPTIO PLACENTA:
1. MARGINAL ( Overt )
 Evident external bleeding, separation begins at the edges.
2. CENTRAL ( Covert )
 Bleeding not evident, placenta separates at the center.
SIGNS AND SYMPTOMS:
1. Painful dark red vaginal bleeding in covert type.
2. Painful bright red vaginal bleeding in overt.
3. Hard, rigid, firm, broad-like abdomen caused by accumulation of blood behind the placenta w/ fetal parts hard to palpate.
4. Abdominal tenderness due to distention of the uterus w/ blood.
5. Sharp pain over the fundus as placenta separates.
6. Signs of shock and fetal distress as the placenta separate.
CLASSIFICATION ACCORDING TO PLACENTAL SEPARATION:
1. Grade 0 – no symptoms of placental separation, diagnosed after delivery when placenta is examined.
2. Grade 1 – some external bleeding, no fetal distress, slight placental separation, no shock
3. Grade 2 – external bleeding, moderate placental separation, uterine tenderness, some evidence of fetal distress
4. Grade 3 – internal and external bleeding, maternal shock and fetal death

PATOPHYSIOLOGY OF ABRUPTIO PLACENTA MEDICINE:
• Tocolytics: Tocolytics are given to stop contractions if your baby is not ready to be born. Contractions are when the muscles of your uterus tighten and loosen.
• Steroids: Steroid medicine may be given if you need to deliver your baby…...

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