Placental Abruption

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Placental Abruption
??????

• Zongjun Hao
• Department of Ob Gy
• Taian public Health School of Shandong Province

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??
??,30?,G1P0 ,36???,2h??????????????????????
????,??60/40 mmHg,???100?/min,????????2?
?,????,???????????
A???????? B?????????? C?????,???????
D??????????
C
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General Consideration

• Definition ??
• The separation of the placenta from its
  site of implantation after 20 weeks of gestation
  or during the course of delivery.
• ??20??????????????????????????????

• perinatal morbidity???
• 0.46-2.1 (our country)
• 1 (other countries)
• perinatal mortality???
• 20-35

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Etiology ??

• Risk factors
• 1?Vascular diseases ????
• preeclampsia, chronic hypertension, renal
  disease.
• ????????????????
• 2?Mechanical factors ?????
• trauma, intercourse etc.
• ?? ???? ??????????

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Etiology ??

• Risk factors
• 3?Supine hypotensive syndrome
• ?????????
• 4?reducing of uterine presure suddenly
• ???????
• multiple gestaion, hytramnios etc.
• 5?others??
• short umbilical cord etc.
• ????????

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Pathology

• Main change ??????
• hemorrhage of the decidua basalis
• ?????

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Pathology change
hemorrhage of the decidua basalis
??????????? ? decidua splits
????? ? decidural hematoma ????? ?
separation, compression, destruction of the
placenta adjacent to it ????????????????
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Pathology
Types?? revealed abruption ????
concealed abruption ???? mixed
abruption ????
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Clinical chracteristics

• Sudden , continuous abdominal pain
• ?????????

• Vaginal bleeding ????

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Complication???

• Uteroplacental apoplexy ??????
• Hypovolemic shock ???????
• Amniotic fluid embolism ????
• Acute renal failure ???????
• Postpartum hemorrhage ????
• DIC ????????

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Treatment

• Treatment of hypovolemic shock ???
• intensive transfusion with blood

• Termination of pregnancy ??????
• promptly
• Cesarean or Vaginal delivery

• Control complications ?????

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homework
???,29?,??35?,???????
?,??????160170/100110mmHg,?????3h???????,???????
?,???????????
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• Thank you !

The End
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Pathology 1
revealed abruption ????
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Pathology 2
concealed abruption ????
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Pathology 3
mixed abruption ?????