Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be talking to you about placental

abruption.

And you can find written notes on this topic at zero to finals.com slash placental abruption

or in the antenatal care section of the zero to finals obstetrics and gynecology book.

So let's get straight into it.

Placental abruption refers to when the placenta separates from the wall of the uterus during pregnancy.

The site of attachment can bleed extensively after the placenta separates.

Placental abruption is a significant cause of antipartum hemorrhage, or bleeding during

pregnancy.

Let's talk about the risk factors.

The risk factors for placental abruption are previous

placental abruption in a previous pregnancy, preeclampsia, bleeding in early pregnancy, trauma,

so consider domestic violence when placental abruption occurs, multiple pregnancy,

fetal growth restriction, somebody who is multi-gravidar,

meaning that they've had a lot of previous pregnancies, increased maternal age, smoking, and cocaine or amphetamine use. Next let's talk about the presentation.

The typical presentation of placental abruption is with sudden onset severe abdominal pain

that is continuous, vaginal bleeding described as antipartum hemorrhage, shock with hypotension

and tachycardia, abnormalities on the CTG indicating fetal distress,

and a characteristic woody feeling to the abdomen on palpation, which would suggest a large hemorrhage.

Next let's talk about the severity of an antipartum hemorrhage. The RCDOG guideline from

2011 defines the severity of antipartum hemorrhage, vaginal bleeding during pregnancy, as spotting,

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