How is abruptio placentae classified?

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

Classification of placental abruption is based on extent of separation (ie, partial vs complete) and location of separation (ie, marginal vs central). (See Clinical.) Clinical classification is as follows:

  • Class 0 - Asymptomatic

  • Class 1 - Mild (represents approximately 48% of all cases)

  • Class 2 - Moderate (represents approximately 27% of all cases)

  • Class 3 - Severe (represents approximately 24% of all cases)

A diagnosis of class 0 is made retrospectively by finding an organized blood clot or a depressed area on a delivered placenta.

Class 1 characteristics include the following:

  • No vaginal bleeding to mild vaginal bleeding

  • Slightly tender uterus

  • Normal maternal BP and heart rate

  • No coagulopathy

  • No fetal distress

Class 2 characteristics include the following:

  • No vaginal bleeding to moderate vaginal bleeding

  • Moderate to severe uterine tenderness with possible tetanic contractions

  • Maternal tachycardia with orthostatic changes in BP and heart rate

  • Fetal distress

  • Hypofibrinogenemia (ie, 50-250 mg/dL)

Class 3 characteristics include the following:

  • No vaginal bleeding to heavy vaginal bleeding

  • Very painful tetanic uterus

  • Maternal shock

  • Hypofibrinogenemia (ie, < 150 mg/dL)

  • Coagulopathy

  • Fetal death

Go to Emergent Management of Abruptio Placentae for complete information on this topic.


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