Materi Presentasi ABRUPTIO PLACENTA.pptx

Materi Presentasi ABRUPTIO PLACENTA.pptx

1. ABRUPTIO PLACENTA

2. DEFINITION a bruptio placenta is the premature separation of the normally implanted placenta from the uterine wall after the 20 week of gestation until the 2 stage of labor.

3. TYPES OF ABRUPTIO d epending upon the extent and region of separation. a complete abruption : occurs when the entire placenta separates. a partial abruption : exist when part of the placenta separates from the uterin e wall. a margina l abruption : occurs when the separation is limited to the edge of the placenta.

4. VARIETIES REVEALED CONCEALED f ollowing separation of the placenta, the blood insinuates downwards between the membranes and the decidua. u ltimately, the blood comes out of the cervical canal to be visible externally. t his is the commonest type. The blood collects behind the separated placenta or collected in between the membranes and decidua. The collected blood is prevented from coming out of the cervix by the presenting part which presses on the lower segment. In this type, some part of the blood collects inside (concealed) and a part is expelled out (revealed). Usually one variety predominates over the othe r. This quite common. MIXED

5. t he prevelence is mor e with : high bird order (pregnancies with gravid 5 and above), advancing age of the mother, poor socio-economic condition, malnutrition, and smoking. h ypertension in pregnancy : pre- eclampsia , gestational hypertension, and essential hypertension. trauma : traumatic separation of the placenta usually leads to its marginal separation with escape of blood outside. s udden uterine decompression : the uterus leads to diminishe d surface area of the uterus adjacent to the placental attachment and result in separation of the placenta. Short cord : either relative or absolute, can bring about placenta separation during labor by mechanical pull. s upine hypotension syndrome : this condition which occurs in pregnancy there is passive engorgement of the uterine and placenta vessels resulting in rupture and extravasation of the blood. p lacental anomaly : circumvallate placenta. s ick placenta : poor placentation. f olic acid deficiency uterine factor t orsion of the uterus c ocaine abuse t hrombophilias p rior abruption RISK FACTORS

6. COMPLICATIONS MATERNAL : M aternal mortality H ypovolaemic shock R enal failure DIC PPH R hesus sesozation C omplication of massive transfusion FETAL : f etal death H ypoxic brain injury IUGR N eonatal anemia C ongenital malformations

7. SIGN AND SYMPTOMS v aginal bleeding u terine tenderness b ack pain f etall distress h ypertonus f etal demise

8. DIAGNOSIS & LABORATORY TEST DIAGNOSIS : h istory and physical examinations triad of external bleeding through cervical Os , uterine or back pain and fetal distress should be high suspicion d efer digital cervical examinations until PP and VP are ruled out. u ltrasound LABORATORY TEST : CBC b lood type and screen u rine analysis l iver function tests r enal fucnction tests p rothrombin time or APTT f ibrinogen levels f ibrin degradation products

9. CLINICAL CLASSIFICATION

10. MANAGEMENT

11. THANK YOU  ANY QUESTION?