Management of Abruptio Placentae

Analyzing 130 cases of abruptio placentae among 26,743 deliveries (1:206), the authors conclude that effective management depends primarily on early recognition of the high-risk patient, immediate hospitalization of all women with third trimester bleeding, prompt institution of liberal whole blood replacement, and early definitive diagnosis. Except when hemorrhage can not be controlled, vaginal delivery should be expected after amniotomy and oxytocin stimulation in mild cases, or if the fetus has died in utero. In moderate and severe cases, if vaginal delivery is not imminent, the viable fetus probably will not survive unless cesarean section is performed as soon as blood replacement has been started and any existing coagulopathy has been corrected.