Placental abruption.

Placental abruption complicates approximately 1% to 2% of all pregnancies and remains a significant cause of both maternal and fetal morbidity. Proposed pathophysiology of both acute placental abruption and the more common partial placental separation are discussed. The contribution of placental abruption to both preterm labor and preterm premature rupture of membranes is discussed. Recent evidence supporting maternal hypertensive disorders, maternal tobacco and cocaine use, age and parity, multiple gestations, maternal thrombophilias, and an unexplained elevated maternal serum alphafetoprotein as risk factors for abruption is reviewed. Emergency management of acute abruption is outlined. Finally, particular emphasis is given to the management of partial placental separation, including both immediate and delayed delivery and the use of tocolysis.

BACKGROUND

Obstetricians and Gynecologists, Family Physicians.

OBJECTIVE

After completion of this article, the reader will be able to define the condition of placental abruption, list the conditions associated with abruption, and outline potential management options for patients with placental abruption.