Comprehensive management of placental abruption: An interprofessional approach

Maria Tigka 1, *, Christina Nanou 2, Eleni Tsoukala 2, Nikolaos Vlachadis 3, Aikaterini Lykeridou 2, Grigorios Karampas 4 and Dimitra Metallinou 2

1 Delivery Room, General and Maternity Hospital “Helena Venizelou”, Athens, Greece.
2 Department of Midwifery, School of Health and Care Sciences, University of West Attica, Athens, Greece.
3 Department of Obstetrics and Gynaecology, General Hospital of Messinia, Kalamata, Greece.
4 Department of Obstetrics and Gynaecology, Aretaieio University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Review Article
World Journal of Advanced Research and Reviews, 2024, 22(03), 350–356
Article DOI: 10.30574/wjarr.2024.22.3.1719
Publication history: 
Received on 27 April 2024; revised on 02 June 2024; accepted on 05 June 2024
Placental abruption (PA) is a major obstetric complication characterized by the premature separation of the placenta from the uterine wall, typically occurring between 20 weeks of gestation and delivery. This condition results from the rupture of decidual vessels, leading to hemorrhage within the placental bed, and poses serious risks to both maternal and fetal health, including maternal hemorrhage, preterm delivery, fetal growth restriction, and perinatal mortality. Despite variations in incidence worldwide, PA remains a leading cause of maternal morbidity and adverse neonatal outcomes. The etiology of PA involves a combination of chronic processes, such as vascular pathology and defective deep placentation, and acute triggers, including mechanical forces exerted on the abdomen. Clinical presentation can range from abdominal pain and vaginal bleeding to uterine contractions and fetal distress, with diagnosis requiring differentiation from other causes of late pregnancy bleeding, such as placenta previa. Effective management of PA necessitates prompt medical intervention, with treatment strategies tailored to the severity of maternal and fetal distress. An interprofessional healthcare team approach is critical, involving obstetricians, anesthesiologists, midwives, radiologists, hematologists, intensivists, and neonatologists to ensure optimal outcomes. The prognosis is heavily influenced by the timing of hospital admission, with early recognition and immediate intervention being paramount to reduce the morbidity and mortality associated with this condition. This narrative review provides a comprehensive overview of PA, highlighting the importance of integrated care to improve maternal and neonatal health outcomes.
Placental Abruption; Epidemiology; Risk factors; Maternal and Neonatal Complications; Treatment and Management; Interprofessional Care
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