ABRUPTIO

PLACENTA

By: Princess Grace A. Pechon, SN

ABRUPTIO PLACENTA
Premature separation of the placenta,
occurs when a normally implanted
placenta separates from the uterine
wall prior to the birth of the infant.
Predisposing
factors
Cocaine use
Smoking
Multipara
Maternal HPN
Previous abruption placenta
Preterm rupture of membranes
Short umbilical cord
Abdominal trauma
Signs and
Symptoms
Persistent abdominal or low back pain that
may be aching or dull
Possible sudden and severe pain
Uterine tenderness that may be localized at

the site of abruption

Uterine irritability with frequent contractions

and poor relaxation between contractions

Persistent high uterine resting tone evident

on fetal monitor
Signs of hypovolemic shock, with or without

external bleeding.
Managemen
t:
Administer IVF, blood, plasma,
cryoprecipitate and platelets as necessary
Prepare for rapid delivery to prevent fetal

compromise and to control bleeding

Keep family informed about interventions

that must often be performed quickly

Acknowledge the familys concern for the

mother and the fetus and offer

reassurance when possible
Nursing
Considerations
Collaborate with physician to administer
intravenous fluids and Rho (D) Immune
globulin
Check laboratory values, Hg, Hct, Blood type

and Rh factor, and clotting factors.

Kleihauer-Betke (K-B) test identifies fetal-

maternal hemorrhage
Keep the mother comfortable

Consider the psychological needs of the family

Complications
Hemorrhage into the decidua basalis
occurs as the placenta separates from
the uterus. Vaginal bleeding usually
follows, although the presence of a
concealed hemorrhage in which the
blood pools behind the placenta is
possible.
Outpatient
Medications in
Abruptio

Placenta
Inpatient and outpatient medications
may include the following:
Prenatal vitamins
Iron supplements
Stool softeners if the patient is

hemodynamically stable and is kept in

an inpatient setting for monitoring