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Placental abruption is the premature separation of the placenta from the uterine wall before delivery, occurring in 0.4-1% of pregnancies. This obstetric emergency can result in maternal hemorrhage, fetal hypoxia, and requires immediate medical intervention to prevent serious complications for both mother and baby.
Abruption occurs when blood vessels in the decidua basalis rupture, causing bleeding between the placenta and uterine wall. This leads to placental separation, compromising maternal-fetal blood exchange and potentially causing disseminated intravascular coagulation (DIC) from tissue thromboplastin release.
Diagnosis relies on clinical presentation including abdominal pain, vaginal bleeding, uterine tenderness, and fetal distress, as ultrasound may miss smaller abruptions. Management depends on severity, gestational age, and maternal-fetal status, ranging from expectant management in mild cases to immediate delivery in severe abruptions with maternal or fetal compromise.
Key imaging focus: Retroplacental hematoma, placental edge separation; US may be NORMAL in abruption