Thursday, September 1, 2011
Placental Abruption
6:30 AM | 
Posted by
Arif Siregar
Etiology and Risk Factors
Primary movement placental abruption is unknown, but there are several related conditions. Incidence increases with maternal age, high parity, race or ethnicity, hypertension (preeclampsia, gestational hypertension, or chronic hypertension), preterm premature rupture of membranes, smoking, cocaine abuse, trombofilia hereditary or acquired, external trauma, and leiomioma uterus.
Pathology
Placental abruption preceded by bleeding into the decidua basalis. Decidua were then separated, leaving a thin layer attached to the myometrium. As a result, this process at the earliest stages showed the formation of decidual hematoma that caused the separation, suppression, and ultimately destruction of the placenta that are nearby. At this early stage, it may not yet have clinical symptoms. This situation is only found on examination of the placenta that is born, which shows the strict bounded basin with a diameter of several centimeters on the surface of maternal blood clot that is covered by a black. Therefore, the newly separated placenta may not differ from normal placenta as it exits.
In a few cases, decidual spiral arteries had ruptured, causing retroplasenta hematoma, which causes more and more as enlarged blood vessels and placenta are released. Part placenta separates rapidly expanded and reached the edge of the placenta. The blood that comes out to separate membranes from the uterine wall and eventually appear as external bleeding, or may remain stuck in the uterus.
Clinical Diagnosis
It is emphasized that the signs and symptoms of placental abruption can vary considerably. For example, external bleeding can be heavy, but the placenta is not too wide apart, so do not directly harm the fetus. Although rare, may not occur external bleeding but the placenta separates total and as a result, the fetus died. In a very unusual case, a multiparous woman ahead of aterm obstetris come into the emergency room because of nosebleed. There was no spontaneous pain or pressure in the abdomen or uterus and no vaginal bleeding, but the fetus died. This patient's blood does not clot and plasma fibrinogen level 25 mg / dl. Patients undergoing induction of labor, and after the fetus out, found a total of placental abruption with fresh clots.
Treatment
Therapy placental abruption will vary depending on gestational age and maternal and fetal status. In the living fetus and mature, and if the vaginal delivery does not occur in the near future, most will choose an emergency cesarean section.
Pathology
Placental abruption preceded by bleeding into the decidua basalis. Decidua were then separated, leaving a thin layer attached to the myometrium. As a result, this process at the earliest stages showed the formation of decidual hematoma that caused the separation, suppression, and ultimately destruction of the placenta that are nearby. At this early stage, it may not yet have clinical symptoms. This situation is only found on examination of the placenta that is born, which shows the strict bounded basin with a diameter of several centimeters on the surface of maternal blood clot that is covered by a black. Therefore, the newly separated placenta may not differ from normal placenta as it exits.
In a few cases, decidual spiral arteries had ruptured, causing retroplasenta hematoma, which causes more and more as enlarged blood vessels and placenta are released. Part placenta separates rapidly expanded and reached the edge of the placenta. The blood that comes out to separate membranes from the uterine wall and eventually appear as external bleeding, or may remain stuck in the uterus.
Clinical Diagnosis
It is emphasized that the signs and symptoms of placental abruption can vary considerably. For example, external bleeding can be heavy, but the placenta is not too wide apart, so do not directly harm the fetus. Although rare, may not occur external bleeding but the placenta separates total and as a result, the fetus died. In a very unusual case, a multiparous woman ahead of aterm obstetris come into the emergency room because of nosebleed. There was no spontaneous pain or pressure in the abdomen or uterus and no vaginal bleeding, but the fetus died. This patient's blood does not clot and plasma fibrinogen level 25 mg / dl. Patients undergoing induction of labor, and after the fetus out, found a total of placental abruption with fresh clots.
Treatment
Therapy placental abruption will vary depending on gestational age and maternal and fetal status. In the living fetus and mature, and if the vaginal delivery does not occur in the near future, most will choose an emergency cesarean section.
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