Asymptomatic placental abruption in the third trimester of pregnancy

This paper provides a literature review on premature separation of the normally implanted placenta (PSNIP), also known as placental abruption or abruptio placentae, a severe pregnancy and childbirth complication. Acute placental abruption is an obstetric complication that causes massive internal bleeding, leading to intrauterine fetal death. The bleeding can also contribute to multiple organ failure, which is responsible for the high rates of maternal and perinatal morbidity and mortality associated with this obstetric complication. Researching various aspects of complications and preventing the occurrence of PSNIP is of great medical and social significance. PubMed and Google Scholar electronic databases were used to analyze placental abruption studies, resulting in over 3,000 sources. After considering keywords, 60 sources were selected and included in the study.Keywords: Placenta, premature separation of the normally implanted placenta, risk factors, pregnancy, preeclampsia, maternal mortality, DIC, Couvelaire uterus.

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Progressive detachment of the normally located placenta: the clinical case of failed maternal death in massive blood loss

Milyaeva

Ковалев

Kulikov

et al. 2023

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Introduction. Despite the global achievements of obstetric science and practice, massive bleeding with premature progressive detachment of the normally located placenta, as well as in placenta previa and ingrowth, hypotonic bleeding, occupy one of the leading positions in the structure of obstetric bleeding and are associated with high rates of nearly dead women (near miss), with maternal and perinatal morbidity and mortality. The purpose of the study was to demonstrate the effectiveness of organizational methodology of emergency care in a 24-hour hospital using the clinical example of PPCR with atypical clinical picture, massive obstetric hemorrhage, and favorable outcome for the patient. Materials and methods. Material for the analysis of the clinical case was an exchange and notification card of a pregnant woman and a parturient and a labor history. Methods: anamnestic data analysis based on the study of official documentation of pregnancy and its outcome, peculiarities of delivery and labor outcome. Results. The analysis demonstrates the possibility of a rapid diagnosis of PPDNLP, which proceeded without the classical triad of symptoms, with a severe course, massive obstetric hemorrhage and timely specialized care, which led to a favorable outcome for the patient. Discussion. The speed of care on admission to the hospital, the timeliness of the correct diagnosis even in the absence of the classical clinical picture of PPDNLP, the equipment of the maternity hospital, the timely and adequate obstetric tactics allowed to avoid maternal mortality in massive blood loss and the presence of the disseminated internal coagulation (DIC) syndrome, complicating PPDNLP. Further study of mechanisms of formation, determination of the most significant predictors and triggers of PPDNLP, improvement of organization of care and planned trainings should make a certain contribution to the improvement of maternal and perinatal morbidity and mortality. Conclusion. In the maternal mortality rate reduction vector, an effective organizational technology of care is demonstrated in a case of PPONR with an atypical clinical picture, the presence of massive obstetric hemorrhage, which ended favorably for the patient.

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Asymptomatic placental abruption in the third trimester of pregnancy

Cited by 3 publications

References 2 publications

Possibilities of ultrasound diagnostics of structural disorders of placenta

Possibilities of ultrasound diagnostics of structural disorders of placenta

Premature Separation of the Normally Implanted Placenta

Progressive detachment of the normally located placenta: the clinical case of failed maternal death in massive blood loss

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