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Abruptio placentae

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Pathological separation of the placenta from its uterine attachment results in a maternal bleed from the opened sinuses.

Initially, the decidua basalis splits, leaving a thin layer adherent to the myometrium. A decidual haematoma is formed with destruction of adjacent placenta.

There is a spectrum of presentation:

  • concealed - no actual bleeding is seen - it remains in the uterus
  • revealed - blood tracks between the membranes and the uterus and escapes vaginally
  • mixed - most usual

Reference

  1. Society for Maternal-Fetal Medicine (SMFM), Gyamfi-Bannerman C. Society for Maternal-Fetal Medicine (SMFM) Consult Series #44: Management of bleeding in the late preterm period. Am J Obstet Gynecol. 2018 Jan;218(1):B2-8.

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