Placental abruption

Last reviewed: 29 Oct 2022
Last updated: 04 Mar 2022

Summary

Definition

History and exam

Key diagnostic factors

  • vaginal bleeding
  • abdominal pain
  • uterine contractions
  • uterine tenderness
More key diagnostic factors

Other diagnostic factors

  • lower back pain
  • fetal death
Other diagnostic factors

Risk factors

  • chronic hypertension
  • preeclampsia
  • smoking
  • cocaine use
  • trauma
  • prior cesarean delivery
  • preterm premature rupture of the membranes
  • multiparity
  • advanced maternal age
  • polyhydramnios
  • chorioamnionitis
  • uterine malformations
  • prior placental abruption
  • multifetal gestations
  • oligohydramnios
  • uterine leiomyomas
  • thrombophilias
More risk factors

Diagnostic investigations

1st investigations to order

  • fetal monitoring
  • Hb and Hct
  • coagulation studies
  • Kleihauer-Betke (K-B) test
  • ultrasound
More 1st investigations to order

Investigations to consider

  • placental pathology
More investigations to consider

Treatment algorithm

INITIAL

all patients

ACUTE

live fetus: >34 weeks

live fetus: ≤34 weeks

fetal demise

Contributors

Authors

Yinka Oyelese, MD, FACOG
Yinka Oyelese

Director, Obstetric Imaging

Beth Israel Deaconess Medical Center

Boston

MA

USA

Disclosures

YO is an author of a number of references cited in this topic.

Anthony M. Vintzileos, MD, FACOG
Anthony M. Vintzileos

Chairman

Department of Obstetrics and Gynecology

Winthrop University Hospital

Mineola

Professor

Obstetrics, Gynecology, and Reproductive Medicine

Stony Brook School of Medicine

Stony Brook

NY

Disclosures

AMV is a consultant for BD (for development of the ODON fetal extraction device).

Peer reviewers

Christopher Glantz, MD, MPH

Professor of Obstetrics and Gynecology

University of Rochester School of Medicine

Rochester

New York

NY

Disclosures

CG declares that he has no competing interests.

Austin Ugwumadu, PhD, FRCOG

Consultant/Senior Lecturer in Obstetrics and Gynaecology

St George's Hospital

London

UK

Disclosures

AU declares that he has no competing interests.

  • Placental abruption images
  • Differentials

    • Preterm labor
    • Placenta previa
    • Chorioamnionitis
    More Differentials
  • Guidelines

    • ACR appropriateness criteria: second and third trimester vaginal bleeding
    • Society for Maternal-Fetal Medicine (SMFM) Consult Series #44: Management of bleeding in the late preterm period
    More Guidelines
  • Patient leaflets

    Appendicitis

    Cystitis

    More Patient leaflets
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