[Abruptio placentae in the data from the obstetrical clinics in Varna, Tolbukhin and Shumen during 1984-1987]

Abruptio placentae was established in 202 pregnancies out of 43,678 pregnancies (0.48%). Pre-eclampsia was diagnosed in 76 women as well (37.6%). Caesarean section was performed in 109 women as vital maternal indications were found in 43 of them. 139 children were born alive (67.8%), but the perinatal mortality was 43.9% (90 children). The maternal mortality was 1.98% (4 women). Caesarean section should be made only in women with alive infant, but obligatory in all cases with severe separation, if preconditions for quick management of delivery by vaginal way lack. Vaginal delivery is recommended in all milder cases and dead fetus, but the duration of delivery should not surpass 6 hours. Total hysterectomy and tamponade of the operative field and vagina should be performed in women with persistent bleedings, but in grave cases a ligature of the hypogastric arteries as well. All interventions should be done after application of intensive infusion, transfusion and other reanimation. The authors propose a scheme for medicamentous treatment.