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BSN 223
Placenta abruptio
Alternative Names
*bleeding
*uterine contractions
*fetal distress
Causes:
• Thrombophili
Clinical Manifestations
Symptoms
• Abdominal pain
• Back pain
• Vaginal bleeding
Exams and Tests
• Abdominal ultrasound
• CBC (0Complete blood count)
• Fibrinogen level
• Partial thromboplastin time
• Pelvic exam
• BUN (Blood urea nitrogen)
• Kleihauer-Betke test - help detect fetal red blood cells in the maternal
circulation.
• Nonstress test
• Bio physical Profile (BPP) - help evaluate patients with chronic
abruptions who are being managed conservatively
Treatment
A. Treatment may fluids through a vein (IV) and blood transfusions.
B. The mother will be carefully monitored for symptoms of shock and the
unborn baby will be watched for signs of distress, which includes an
abnormal heart rate.
C. An emergency cesarean section may be necessary. If the fetus is very
immature and there is only a small placenta rupture, the mother may
be kept in the hospital for close observation and released after several
days if the condition does not get worse
D. If the fetus is developed (matured) enough, vaginal delivery may be
chosen if there is minimal distress to the mother and child. Otherwise,
a cesarean section may be the preferred choice.
The following increase the risk for death in both the mother and
baby:
• Absence of labor
• Closed cervix
• Delayed diagnosis and treatment of placenta abruption
• Excessive blood loss resulting in shock
• Hidden (concealed) vaginal bleeding in pregnancy
Possible Complications
Prevention
Medications
*Tocolytics
May allow for effective administration of glucocorticoids to the preterm fetus
to accelerate fetal lung maturation. In chronic abruption, may also help delay
delivery to a gestational age when complications of prematurity are less
severe.
*Magnesium Sulfate
Nursing Management