Abruptio placentae and disseminated intravascular coagulopathy

Hall, David R.

doi:10.1053/j.semperi.2009.02.005

Cited by 74Maternal and fetal healthcarePregnancy and preeclampsia studiesBlood Coagulation and Thrombosis Mechanisms

Abruptio placentae and disseminated intravascular coagulopathy

Hall, David R.·2009·Seminars in Perinatology

DOI 10.1053/j.semperi.2009.02.005

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Abstract

Abruptio placentae is an important cause of vaginal bleeding in the latter half of pregnancy. The key factor in the pathophysiology is hemorrhage at the decidual-placental interface. Small episodes may escape clinical detection, but severe grades impact significantly on fetal and maternal morbidity and mortality, with the most frequent complications being fetal death, severe maternal shock, disseminated intravascular coagulopathy, and renal failure. Important risk factors for the development of abruptio placentae are previous abruption, hypertensive diseases, abdominal trauma, growth restriction, and smoking. The diagnosis is essentially made on the clinical picture that includes vaginal bleeding (usually dark blood), abdominal pain, and uterine contractions. The essence of management is restoration of circulating volume followed by delivery of the fetus and placenta, most often by cesarean section when the diagnosis is clear and the fetus alive and viable. Aggressive resuscitation and expeditious vaginal delivery are the goals when the fetus is dead.

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The histologic finding that appears to be most strongly associated with acute abruption is hemorrhage in the decidua basalis with underlying parenchymal indentation.
“The histologic finding that appears to be most strongly associated with acute abruption is hemorrhage in the decidua basalis with underlying parenchymal indentation (FIGURE 11) (75).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [75]

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Authors: Hall, D. R.
Affiliations: Stellenbosch University (ZA)
Corresponding author: Hall, David R.
ORCID: Hall, David R.
Venue: Seminars in Perinatology
Publisher: Elsevier BV
Published: 2009-06
Volume: 33
Issue: 3
Pages: 189-195
ISSN: 0146-0005 (ISSN-L)
DOI: 10.1053/j.semperi.2009.02.005
OpenAlex: W2124705252
Cited by: 74
References: 41
Citations by year: 2026: 5 · 2025: 5 · 2024: 5 · 2023: 6 · 2022: 4 · 2021: 1 · 2020: 4 · 2019: 4 · 2018: 5 · 2017: 4 · 2016: 5 · 2015: 5 · 2014: 5 · 2013: 4 · 2012: 5
FWCI: 0.55
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Seminars in Perinatology (publishedVersion)
PubMed (publishedVersion)
SUNScholar (Stellenbosch University) (submittedVersion)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
Keywords: placental abruption, disseminated intravascular coagulation, maternal shock, fetal death, risk factors, diagnosis, cesarean section, resuscitation, hypertensive disorders of pregnancy, renal failure
MeSH terms: Abruptio Placentae, Disseminated Intravascular Coagulation, Female, Humans, Pregnancy, Risk Factors, Shock, Hemorrhagic

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Abruptio placentae and disseminated intravascular coagulopathy

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