Placental abruption

If abruption occurs at preterm gestations, conservative management may be employed in cases in which both fetus and mother are stable. Cases must be managed on a case-by-case basis, determined by the clinical scenario and risk of adverse outcomes. These cases require close monitoring and evaluation of both the maternal and the fetal status. This includes a combination of regular sonograms, fetal heart rate monitoring, and biophysical profiles. The mother may occasionally be managed as an outpatient, but only if she is both stable and reliable. She should be instructed to report immediately should she experience bleeding, severe abdominal pain, contractions, or reduced fetal movements.

Placental pathology may help cast light on the etiology and pathophysiology of the abruption. Lesions such as placental thrombosis, perivillous fibrin deposition, infarction, and decidual lesions may be found.