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• Abruptio Placenta:

  • Usually happens on the 2nd or 3rd trimester of pregnancy
  • Is the premature separation of the placenta that occurs late in the pregnancy
  • Appears to have been implanted correctly but begins to separate and bleeding results
• Signs of internal bleeding in abruptio placenta:

  • Distended
  • Rigid
  • Tenderness
• 3 signs of placental separation:

  1. Sudden gush of blood

  2. Lengthening of the cord

  3. Globular shape of the uterus
• Types of placental separation:

  • Fetal anoxia: inadequate oxygenation of the mother, low maternal blood pressure, or abnormalities in the uterus, placenta, or umbilical cord that result in inadequate blood flow to the fetus
• Risk factors for placental separation:

  1. High Parity - giving birth multiple times

  2. Short umbilical cord - can cause separation that leads to bleeding

  3. Advanced maternal age

  4. Direct trauma

  5. Chorioamnionitis - maternal infection
• Diagnostic test for abruptio placentae:

  • Hemoglobin level and Fibrinogen level tests are performed to rule out disseminated intravascular coagulation
• Medical management for abruptio placentae:

  • Intravenous therapy
  • Oxygen inhalation administered via facemask to prevent fetal anoxia
  • Fibrinogen determination test taken several times before birth to detect DIC
• Surgical management for abruptio placentae:

  • Cesarean delivery
  • Hysterectomy (removal of uterus)
• Nursing interventions for abruptio placentae:

  • Place in lateral position
  • Monitor fetal heart sounds
  • Monitor vital signs
• In Diabetes Mellitus:

  • No D5-Give ( PLR) for blood loss
  • D5LR for blood loss and food nutrition