Abruptio Placenta

Presentation: Patient presents with vaginal bleeding, abdominal pain, and uterine tenderness. Basically shows itself by painful 3rd trimester bleeding.
Note: The absence of hemorrhage does not rule out this diagnosis.

Differential Diagnosis:
- Placenta Previa: absence of bleeding rules out this Diagnosis. Also this usually shows itself by painless 3rd trimester bleeding.

Risk Factors:
- HT
- Preecclampsia,
- History of previous Abruption placenta
- Trauma
- Short umbilical cord
- Cocaine abuse.

Complications: DIC is of the most common complications of Abruptio Placenta in pregnancy, which results from a release of activated thromboplastin from the decidual hematoma in to maternal circulation. Risk factors for DIC are smoking and Folate deficiency. It can progress rapidly so careful monitoring is mandatory.
Treatment: Once Diagnosis is made, large-bore IV, as well as Foley catheter is inserted. Patients with Abruptio placenta in labor should be managed aggressively to insure rapid vaginal delivery, since this will remove the inciting cause of DIC and hemorrhage. Now if Patient is stable tocolysis with MgSO4 is considered. Again, once we Diagnosis the next step is Vaginal delivery with augmentation of labor if necessary. Now if mother and baby are not stable or if there is contraindicated, then Emergency C-section is indicated.