Placenta Abruption

Before Childbirth

Placental abruption is when the placenta prematurely separates from the uterine wall, leading to bleeding and impaired oxygen delivery to the fetus. It’s an obstetric emergency.

• Concern for? Hemorrhagic → Shock, DIC

• Causes:     

  • 1. Trauma    

  • 2. Previous placental abruption

  • 3. Chronic HTN

  • 4. Preeclampsia

  • 5. PROM

  • 6. smoking/cocaine

  • 7. Multiparity

  • WE CANNOT PREVENT!

  • S+S = Dark vaginal bleeding with extended fundal height, PAIN, HARD abdomen, decreased fetal movements, faint, nausea, visible blood l

🩺 Vital Signs to Monitor

Mother

• Blood Pressure (BP)

  • May be normal early, then ↓ (hypotension) with blood loss

• Heart Rate (HR)

  • ↑ Tachycardia (compensating for hemorrhage)

• Respiratory Rate (RR)

  • ↑ with pain, anxiety, or shock

• Oxygen Saturation

  • May ↓ if severe compromise

• Temperature

  • Usually normal

Fetus

• Fetal Heart Rate (FHR)

  • Early: Tachycardia

  • Late/Severe:

    • Bradycardia

    • Late decelerations

    • Possible fetal demise

⚠ What You Expect to See

Classic Findings

• Painful vaginal bleeding (may be dark red)

• Severe abdominal or back pain

• Rigid, board-like uterus 🧱

• Uterine tenderness

• Frequent contractions or uterine irritability

⚠ Important Note

• Bleeding can be concealed (internal), so:

  • Amount of visible blood may NOT reflect severity

🚨 Signs of Worsening Condition

• Hypovolemic shock

  • ↓ BP, ↑ HR

  • Cool, clammy skin

  • Confusion

• Decreased urine output

• Disseminated intravascular coagulation (DIC) (serious complication)

  • Bleeding from IV sites, gums, etc.