What are the possible complications of abruptio placentae?

Updated: Nov 30, 2018
  • Author: Shad H Deering, MD; Chief Editor: Carl V Smith, MD  more...
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Answer

Hemorrhage into the decidua basalis occurs as the placenta separates from the uterus. Vaginal bleeding usually follows, although the presence of a concealed hemorrhage in which the blood pools behind the placenta is possible. (See Workup.)

Hematoma formation further separates the placenta from the uterine wall, causing compression of these structures and compromise of blood supply to the fetus. Retroplacental blood may penetrate through the thickness of the uterine wall into the peritoneal cavity, a phenomenon known as Couvelaire uterus. The myometrium in this area becomes weakened and may rupture with increased intrauterine pressure during contractions. A myometrium rupture immediately leads to a life-threatening obstetric emergency. (See Treatment.)


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