What is the role of cesarean delivery in the treatment of abruptio placentae?

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

Cesarean delivery is often necessary for fetal and maternal stabilization.

While cesarean delivery facilitates rapid delivery and direct access to the uterus and its vasculature, it can be complicated by the patient's coagulation status. Because of this, a vertical skin incision, which has been associated with less blood loss, is often used when the patient appears to have DIC.

The type of uterine incision is dictated by the gestational age of the fetus, with a vertical or classic uterine incision often being necessary in the preterm patient.

If hemorrhage cannot be controlled after delivery, a cesarean hysterectomy may be required to save the patient's life.

Before proceeding to hysterectomy, other procedures, including correction of coagulopathy, ligation of the uterine artery, administration of uterotonics (if atony is present), packing of the uterus, and other techniques to control hemorrhage, may be attempted.


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