Placental abruption
Abstract
Placental abruption complicates about 1% of pregnancies and is a leading cause of vaginal bleeding in the latter half of pregnancy. It is also an important cause of perinatal mortality and morbidity. The maternal effect of abruption depends primarily on its severity, whereas its effect on the fetus is determined both by its severity and the gestational age at which it occurs. Risk factors for abruption include prior abruption, smoking, trauma, cocaine use, multifetal gestation, hypertension, preeclampsia, thrombophilias, advanced maternal age, preterm premature rupture of the membranes, intrauterine infections, and hydramnios. Abruption involving more than 50% of the placenta is frequently associated with fetal death. The diagnosis of abruption is a clinical one, and ultrasonography and the Kleihauer-Betke test are of limited value. The management of abruption should be individualized on a case-by-case basis depending on the severity of the abruption and the gestational age at which it occurs. In cases where fetal demise has occurred, vaginal delivery is preferable. Disseminated intravascular coagulopathy should be managed aggressively. When abruption occurs at or near term and maternal and fetal status are reassuring, conservative management with the goal of vaginal delivery may be reasonable. However, in the presence of fetal or maternal compromise, prompt delivery by cesarean is often indicated. Similarly, abruption at extremely preterm gestations may be managed conservatively in selected stable cases, with close monitoring and rapid delivery should deterioration occur. Most cases of placental abruption cannot be predicted or prevented. However, in some cases, maternal and infant outcomes can be optimized through attention to the risks and benefits of conservative management, ongoing evaluation of fetal and maternal well-being, and through expeditious delivery where appropriate.
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Abruption complicates 0.6-1.2% of pregnancies.
“Abruption occurs in 0.6–1.2% of all pregnancies, with nearly half of abruption occurring at term gestations.”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [4]
Approximately half of abruption occurs at term gestations.
“with nearly half of abruption occurring at term gestations.”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [4]
Pregnant people who experience abruption have increased risk of hysterectomy.
“Pregnant people who experience abruption have increased risks of hemorrhagic shock, DIC, need for blood transfusion, and hysterectomy.”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [4]
Pregnant people who experience abruption have increased risk of DIC.
“Pregnant people who experience abruption have increased risks of hemorrhagic shock, DIC, need for blood transfusion, and hysterectomy.”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [4]
Postpartum risks of abruption include intensive care unit admission.
“Risks in the postpartum period also include intensive care unit admission and maternal death (4).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [4]
Postpartum risks of abruption include maternal death.
“Risks in the postpartum period also include intensive care unit admission and maternal death (4).”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [4]
Pregnant people who experience abruption have increased risk of need for blood transfusion.
“Pregnant people who experience abruption have increased risks of hemorrhagic shock, DIC, need for blood transfusion, and hysterectomy.”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [4]
Pregnant people who experience abruption have increased risk of hemorrhagic shock.
“Pregnant people who experience abruption have increased risks of hemorrhagic shock, DIC, need for blood transfusion, and hysterectomy.”
From Placental abruption at near-term and term gestations: Pathophysiology, epidemiology, diagnosis, and management (2023) · cites this paper as [4]
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- Authors
- Oyelese, Y., & Ananth, C. V.
- Venue
- Obstetrics & Gynecology
- Published
- 2006-10
- Volume
- 108
- Issue
- 4
- Pages
- 1005-1016
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W4244302144
- Cited by
- 508
- References
- 40
- Citations by year
- 2026: 25 · 2025: 30 · 2024: 29 · 2023: 24 · 2022: 36 · 2021: 25 · 2020: 27 · 2019: 27 · 2018: 35 · 2017: 26 · 2016: 25 · 2015: 32 · 2014: 24 · 2013: 24 · 2012: 22
- FWCI
- 2.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD038902)
- 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 › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- placental abruption, risk factors, perinatal mortality, Kleihauer-Betke test, ultrasonography, conservative treatment, cesarean section, vaginal delivery, disseminated intravascular coagulation, preeclampsia, thrombophilia, fetal death
- MeSH terms
- Abruptio Placentae, Female, Gestational Age, Humans, Pregnancy, Risk Factors, Tocolysis, Ultrasonography, Prenatal, Thrombophilia
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