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Define Placental Abruption
Premature separation of normally implanted placenta
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Risk Factors for Placental Abruption
- HTN - any type, especially CHTN+SI PreEc
- Trauma
- Smoking
- Cocaine use
- Hx of abruption
- Age
- PROM
- LBW/FGR
- Oligohydramnios
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Signs/Symptoms of Placental Abruption
- Profuse (or no) bleeding
- Abdominal pain (+/-) may cause rigidity or demeanor out of proportion to objective signs
- Frequent, low-amplitude ctx. on monitor
- Fetal distress - recurrent/late decels; loss of variability; bradycardia; sinusoidal pattern
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Management of Placental Abruption
- Call MD
- VS, mental status, pallor, visualize blood loss
- IVF, blood replacement, O2
- Continuous EFM
- Labs: CBC, coags (fibrinogen, PR/INR, F-VLeiden)
- Prepare for CS - abruption can become complete at any time
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