How is the physical exam to evaluate abruptio placentae performed?

Updated: Nov 30, 2018
  • Author: Shad H Deering, MD; Chief Editor: Carl V Smith, MD  more...
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The physical examination of a patient who is bleeding must be targeted at determining the origin of the hemorrhage. Simultaneously, the patient must be stabilized quickly. With placental abruption, a relatively stable patient may rapidly progress to a state of hypovolemic shock.

Do not perform a digital examination on a pregnant patient with vaginal bleeding without first ascertaining the location of the placenta. Before a pelvic examination can be safely performed, an ultrasonographic examination should be performed to exclude placenta previa. [17] If placenta previa is present, a pelvic examination, either with a speculum or with bimanual examination, may initiate profuse bleeding.

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