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RETROPLACENTAL /
INTAPLACENTAL HEMATOMA PLACENTAL ABRUPTION |
Placental abruption is characterized by spontaneous behind or within the
placenta. It may result from extravasation of maternal or fetal blood.
Hematomas of fetal origin are secondary to rupture of a chorionic vessel before
or during delivery, and are localized under the amniotic layer (subamniotic)
covering the fetal plate.
Hematomas of maternal origin result in placental abruption and presents as vaginal bleeding.
CLINICALLY
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Classical triad of pain / cramping, vaginal bleeding and onset of labor /
delivery.
PATHOGENESIS
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Pathogenesis is debated but it is strongly associated with pre-eclampsia and
chronic essential hypertension. Hemorrhage is believed to be caused by rupture
of the maternal decidual arterioles in vessels weakened by the vascular
changes. Hemorrhage may occur in normal vessels and in patients without pre
eclampsia.
ULTRASOUND
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OUTCOME
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Perinatal mortality approaches 25%.