Timely Treatment And Management Of Placental Abruption: An Interesting Clinical Case And Short Review
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Abstract
Placental abruption is a case where the placenta is in the correct position but peels off prematurely before the fetus comes out. The term placental abruption does not include cases of partial peeling of the lower pole of the placenta previa, i.e. cases where the placenta is located near or coverning the opening of the cervix.1-6 The incidence of placental abruption during pregnancy ranges from 0.4-1.0%.7-15 In placental abruption, due to the placenta peeling off the lining, the oxygen exchange between mother and fetus is completely interrupted, leading to fetal distress in labor and very high mortality during labor. Placental abruption is classified into 4 different types depending on the severity and symptoms of this disease: hidden, mild, moderate, and severe placental abruption.16,17
Placental abruption was officially described and published in 1901 with Holmes's extensive survey including 199 cases.18 DeLee was the one who described placental abruption due to rupture of vascular components in 1982.19 Any agent that disrupts the way the placental blood vessels attach to the uterine wall causes placental abruption; Disease, external trauma, placental abnormalities, exposure to toxic chemicals during pregnancy, and rapid rupture of amniotic fluid can all be causes of placental abruption. Complications of placental abruption include shock due to blood loss, bleeding due to decreased fibrinogenesis, acute kidney failure, premature birth, and death of mother and child. Placental abruption is an obstetric emergency, its severe course threatens the life of the fetus and mother, and is the leading cause of maternal death (2-5%) and fetal death (10-15%).16,17,20,21
Perinatal mortality in placental abruption is very high and can be up to 25%. Importantly, even when revived, newborns can have serious brain sequelae, with 15-20% of survivors having later neurological sequelae16,17, When placental abruption occurs, the development can be very rapid and unpredictable, requiring quick diagnosis, timely decisions, and treatment. Therefore, we report a clinical case of placental abruption with rapid and unpredictable progression from mild to severe at an International Hospital in Vietnam to share more clinical situations in placental abruption.
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References
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