Placental abruption

Placental abruption is the premature separation of normally implanted placenta after the 20th week of pregnancy, usually with heavy bleeding.

Two types of placental tear:

Hidden hemorrhage - the placenta separation center, and a large amount of blood collected in the placenta.

External hemorrhage - the separation of the placenta along the border, and the flow of blood through the membrane of the cervix.

Risk factors:

Uterine abnormalities
Multiparous
Pre-eclampsia
Previous Caesarean
Kidney disease or
Abdominal trauma
Previous semester bleeding
Abnormally large placenta
Short umbilical cord

Common clinical signs:

Intense local cancer pain, with or without vaginal bleeding
Hide or external bleeding dark red
Uterus to find a motherboard with severe chronic pain
Contractions of the uterus
Uterine contour can enlarge or change shape
WLH presence or absence
Fruit of the presentation may be included

Nursing Management:

Continuous assessment of maternal and fetal physiological status, namely:

Vitals
Bleed
Electronic fetal monitoring tracings and maternal
Signs of shock - a rapid pulse, cold clammy skin, lowers blood pressure
Reduction of urinary
Never vaginal or rectal examination or any steps that would stimulate uterine activity take.

The assessment of the need for immediate delivery. If the client is active and bleeding can be stopped with bed rest may need a caesarean section is indicated.

Ensure appropriate management.
At the reception, at the place of women in bed to ensure printing position to avoid vena cava.
Add multiple intravenous catheter into a large vein in the fluid replacement. Obtaining blood samples for fibrinogen.
Monitor and measure vital signs outside WLH mother every 5-15 minutes. Application of oxygen to the mother in the mask.
Prepare for Caesarean section, which is the method of choice for birth

Provide client and family education.

Address emotional and psychosocial needs. Results for the mother and the fetus depends on the degree of separation, the amount of fetal hypoxia and quantity of bleeding.