Which of the following signs indicate that the placenta has separated and is ready to be delivered Select all that apply?
Show
SummaryRead the full fact sheet
This page has been produced in consultation with and approved by:
This page has been produced in consultation with and approved by: Related information
From other websitesContent disclaimerContent on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. Abruptio placentae is premature separation of a normally implanted placenta from the uterus, usually after 20 weeks gestation. It can be an obstetric emergency. Manifestations may include vaginal bleeding, uterine pain and tenderness, hemorrhagic shock, and disseminated intravascular coagulation. Diagnosis is clinical and sometimes by ultrasonography. Treatment is modified activity (eg, a woman's staying off her feet for most of the day) for mild symptoms and prompt delivery for maternal or fetal instability or a near-term pregnancy. Abruptio placentae and other obstetric abnormalities increase the risk of morbidity or mortality for the woman, fetus, or neonate. Abruptio placentae occurs in 0.4 to 1.5% of all pregnancies; incidence peaks at 24 to 26 weeks gestation. Abruptio placentae may involve any degree of placental separation, from a few millimeters to complete detachment. Separation can be acute or chronic. Separation results in bleeding into the decidua basalis behind the placenta (retroplacentally). Most often, etiology is unknown. Risk factors for abruptio placentae include the following:
Complications of abruptio placentae include the following:
Symptoms and Signs of Abruptio PlacentaeSeverity of symptoms and signs depends on the degree of separation and blood loss. Acute abruptio placentae may result in bright or dark red blood exiting through the cervix (external hemorrhage). Blood may also remain behind the placenta (concealed hemorrhage). As separation continues, the uterus may be painful, tender, and irritable to palpation. Hemorrhagic shock may occur, as may signs of DIC. Chronic abruptio placentae may cause continued or intermittent dark brown spotting. Abruptio placentae may cause no or minimal symptoms and signs.
The diagnosis of abruptio placentae is suspected if any of the following occur after the 1st trimester:
Evaluation for abruptio placentae includes the following:
Fetal heart monitoring may detect a nonreassuring pattern or fetal death. Transvaginal ultrasonography is necessary if placenta previa is suspected based on transabdominal ultrasonography. However, findings with either type of ultrasonography may be normal in abruptio placentae.
Prompt cesarean delivery is usually indicated if abruptio placentae plus any of the following is present, particularly if vaginal delivery is contraindicated:
Once delivery is deemed necessary, vaginal delivery can be attempted if all of the following are present:
Hospitalization and modified activity (modified rest) are advised if all of the following are present:
This approach ensures that mother and fetus can be closely monitored and, if needed, rapidly treated. (Modified activity involves refraining from any activity that increases intra-abdominal pressure for a long period of time—eg, women should stay off their feet most of the day. Women should be advised to refrain from sexual intercourse. Corticosteroids should be considered (to accelerate fetal lung maturity) if gestational age is < 34 weeks. Corticosteroids may also be given if all of the following are present:
If bleeding resolves and maternal and fetal status remains stable, ambulation and usually hospital discharge are allowed. If bleeding continues or if status deteriorates, prompt cesarean delivery may be indicated. Complications of abruptio placentae (eg, shock, DIC) are managed with aggressive replacement of blood and blood products.
Click here for Patient Education What are the 4 signs of placental separation?Signs and symptoms of placental abruption include:. Vaginal bleeding, although there might not be any.. Abdominal pain.. Back pain.. Uterine tenderness or rigidity.. Uterine contractions, often coming one right after another.. Which of the following signs indicate that the placenta has separated and is ready to be delivered quizlet?The labor process has now entered the third stage, ie, delivery of the placenta. Three classic signs indicate that the placenta has separated from the uterus: (1) The uterus contracts and rises, (2) the cord suddenly lengthens, and (3) a gush of blood occurs.
Which signs suggest that the placenta has separated?What are the symptoms of placental abruption? The main symptom of placental abruption is vaginal bleeding. You also may have pain,contractions, discomfort and tenderness or sudden, ongoing belly or back pain. Sometimes, these symptoms may happen without vaginal bleeding because the blood is trapped behind the placenta.
How do you know when your placenta is ready to be delivered?Signs that the placenta is beginning to separate include: A sudden gush of blood. Lengthening of the visible portion of the umbilical cord. The uterus, which is usually soft and flat immediately after delivery, becomes round and firm.
|