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Clinical and haematological problems associated with severe abruptio placentae
South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|September 16, 1978
Summary
Severe placental abruption leading to fetal death requires significant blood transfusion and carries a low risk of maternal mortality. Coagulation studies revealed diffuse intravascular coagulation, which resolved postpartum.
Area of Science:
- Obstetrics
- Maternal-Fetal Medicine
- Hematology
Background:
- Abruptio placentae is a significant obstetric emergency.
- Severe cases can lead to fetal demise and maternal complications.
Purpose of the Study:
- To evaluate maternal outcomes and management in severe abruptio placentae with fetal death.
- To assess the incidence of coagulopathy in this patient cohort.
Main Methods:
- Clinical study of 80 patients with severe abruptio placentae and intrauterine fetal death.
- Monitoring of central venous pressure for fluid management.
- Serial coagulation studies in 58 patients.
- Analysis of blood replacement, caesarean section rates, and maternal complications.
Main Results:
- Average blood replacement of 5 units per patient.
- Caesarean section incidence of 21%.
- Only one case of renal failure requiring peritoneal dialysis.
- No maternal deaths occurred.
- Diffuse intravascular coagulation was prevalent but normalized postpartum.
Conclusions:
- Severe abruptio placentae with fetal death can be managed effectively with vigilant monitoring and timely intervention.
- Maternal mortality is preventable with adequate fluid and blood replacement.
- Postpartum normalization of coagulation parameters suggests a transient nature of the coagulopathy.