Placenta Abruption.pptx

Presentation on placental abruption, with risk factor, complications, treatment and severity

1. Placental Abruption By Syed M ohammad A rish A yub

2. Placenta

3. Placental abruption Premature separation of placenta from uterine wall before delivery of a baby. In 0.5 to 1.3% of cases Severe abruption can lead to death.

4. P athophysiology Placental abruption occurs when the maternal vessels tear away from the placenta and bleeding occurs between the uterine lining and the maternal side of the placenta.

5. Types Partial Placental abruption  Complete or Total Placental abruption Revealed Placental abruptions Concealed Placental abruptions

6. Risk factors Trauma Previous placental abruption. Multiple gestations (twins or triplets). High blood pressure (hypertension),  gestational diabetes or   preeclampsia. If you smoke or have a history of drug use. Short umbilical cord .

7. Uterine fibroids. Thrombophilia (a blood clotting disorder). Premature rupture of membranes (the water breaks before the fetus is full term). Rapid loss of the amniotic fluid.

8. Diagnosis Fetal heart monitoring CBC (complete blood count) Blood and Rh typing PT/PTT Serum fibrinogen and fibrin-split products Pelvic ultrasonography Kleihauer-Betke test

9. Classification based on clinical finding Class 0: Asymptomatic Discovery of a blood clot on the maternal side of a delivered placenta Diagnosis is made retrospectively Class 1: Mild No sign of vaginal bleeding or a small amount of vaginal bleeding. Slight uterine tenderness No signs of fetal distress

10. Class 2: Moderate moderate amount of vaginal bleeding Significant uterine tenderness with tetanic contractions M aternal tachycardia. Evidence of fetal distress Clotting Class 3: Severe heavy vaginal bleeding Tetanic uterus/ board-like consistency on palpation Maternal shock Clotting Fetal death

11. C omplications Placental abruption can cause life-threatening problems for both mother and baby. For the mother, placental abruption can lead to : Hypovolemic Shock due to blood loss Blood clotting problems The need for a blood transfusion Failure of the kidneys or other organs resulting from blood loss Rarely, the need for hysterectomy, if uterine bleeding can't be controlled

12. For the baby, placental abruption can lead to: Restricted growth from not getting enough nutrients Not getting enough oxygen Premature birth Stillbirth Death

13. Treatment Monitoring – to ensure both baby and mother are stable. Hospitalization – If abruption is moderate to severe Medication Vaginal delivery C section

14. On the basis of severity Mild abruption Observe the patient and monitor carefully the labor and delivery IV drip start with ringer lactate, normal saline DNS and make arrangements for blood transfusion Position the patient in left lateral position Moderate Perform amniotomy and initiate an oxytocin induction Attempt vaginal delivery first If uterus feel hypotonic during labor or sign of fetal distress then c section Maintain iv fluid Blood transfusion

15. Severe with dead fetus Start IV drip and give IV fluids Catheterize the patient and monitor urine output which should be maintained 30ml/ hr Oxytocin may be given to induce and sustain labor Destructive operation is done to extract the fetus Severe abruption with live fetus At least 4 unit of blood is kept ready C section is performed if cervix is not dilated Maintain iv fluid, crystalloid, colloids and blood Monitor vital sign, FHR and urine output every hour.