Placental Abruption

Abruptio placentae
is defined as the
premature
separation of the
placenta from the
uterus.
 Ethiopathogenesis
Placental abruption is initiated by hemorrhage
into the decidua basalis. The decidua then
splits, leaving a thin layer adhered to the
myometrium. Consequently, the process
begins as a decidual hematoma and expands
to cause separation and compression of the
adjacent placenta.
 Etiologi
1. Demographic factors
2. Hypertension and preeclampsia
3. Preterm Prematurely Ruptured Membranes
4. Cigarette Smoking
5. Cocaine Abuse
6. Uterine Leiomyomas
7. Recurrent abruption
 Symptoms
• Abdominal pain
• Vaginal bleeding
• Uterine tenderness or back pain
• Frequent contractions and persistent
hypertonus
• Fetus dead
 complications
Mother Fetus
• Hypovolemik shock • Fetal distress
• Consumptive • Hipoksia
coagulopathy • Disorders of
• Couvelaire uterus growth/development
• Acute kidney injury • Anemia
• Sheehan syndrome • Fetal death
 Management
Treatment of the woman with a placental
abruption varies depending primarily on her
clinical condition, the gestational age, and the
amount of associated hemorrhage. With a
living viable-size fetus and with vaginal
delivery not imminent, emergency cesarean
delivery is chosen by most.
 Management
1. Sectio saesarean
2. Vaginal delivery
 Diferensial Diagnosis
• Placenta Previa