Abruptio Placenta Pathophysiology

• Abruptio placentae


  Detachment of the placenta before the birth of the baby
• Abruptio placentae


  • Can be a partial detachment or a total detachment of the placenta from the uterine wall
• Placenta's role


  Maintains pregnancy, delivers oxygen and nutrients to baby, removes waste from baby via umbilical cord
• Placenta should normally detach from uterine wall after birth
• Placenta can detach prematurely in abruptio placentae, causing issues</b>
• What can happen when placenta detaches

  • Concealed bleeding inside uterus
  • Release of thromboplastin into mother's circulation, leading to disseminated intravascular coagulation (DIC)
• Causes of abruptio placentae


  • Chronic hypertension
  • Preeclampsia
  • Previous abruptio placentae
  • Trauma to abdomen
  • Cocaine use
  • Smoking
  • Premature rupture of membranes
  • Multiple pregnancy
• Dark red bleeding


  Occurs because bleeding has been concealed and is not bright red
• Signs and symptoms of abruptio placentae


  • Dark red bleeding
  • Extended fundal height
  • Tender uterus
  • Abdominal pain/contractions
  • Concealed bleeding
  • Hard, rigid abdomen
  • Experience of DIC
  • Distressed baby
• Nursing interventions for abruptio placentae

  1. Monitor for DIC (check labs like platelets, fibrinogen, prothrombin)

  2. Monitor for bleeding (concealed or visible)

  3. Place patient on left side

  4. External fetal monitoring

  5. Obtain IV access, type and cross-match blood

  6. Prepare for delivery (vaginal or emergency C-section)