Chapter 217 Placental Abruption
Description: Placental abruption is premature separation of an otherwise normally implanted placenta before delivery of the fetus.
Prevalence: One in 185 to 290 deliveries; sufficient to result in fetal death, 1 in 1600 deliveries (approximately 10% of third-trimester fetal demise).
Causes: Pregnancy-induced hypertension (most common), trauma to the abdomen, decompression of an overdistended uterus (loss of amniotic fluid, delivery of a twin), cocaine use.
Risk Factors: Pregnancy-induced hypertension (most common). Prior abruption: 15% chance if one prior episode, 20% to 25% for two or more prior events. Others: smoking >1 pack/day (2-fold increased risk), multiparity, alcohol abuse, cocaine use, polyhydramnios, maternal hypertension, premature rupture of the membranes, external trauma, uterine leiomyomata, increased age or parity, and multiple gestation.
Associated Conditions: Hypertension, pre-eclampsia, eclampsia, intrauterine fetal demise, postpartum hemorrhage, consumptive coagulopathy, tumultuous labor, premature delivery, and fetal bradycardia.
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