Abruptio Placenta

Clinical Features:

• Severe Lower abdominal Pain
• Nauseas&Vomiting

Per abdominal Examination:

• Fetal movement abscent 
• Abdomen woody hard type 

Per vaginal examination:

• Dark color bleeding -Revealed type 
• no bleeding - Concealed type

Investigations:

• CBC 
• BT& CT 
• USG Of P/P 
• Blood grouping & Rh typing 
• RBS
• HbsAg 
• Urine RME

Rx:(Indoor)

• Diet: NPO
• Complete bed rest 
• 02 inhalation stat & sos
• contineous catheterization 
• Blood transfusion : if needed 
• Monitor vital signs

1. Inf. Hartsol (2L) 

• 30 drop/min

2. Inj.Oricef (ceftriaxone) (1gm)

• 1 vial I/V ....stat & BD 

3. Inj. Viset (Tiemonium)(5mg)

• 2 vial I/V stat & TDS 

4. Inj.Esonix (esomeprazole) (40mg) 

• 1 vial I/V stat& BD 

5. Inj.Xamic (Tranexamic acid)(500mg)

• 1 ample I/V stat & TDS 

If BP is Low :

Inj.Plasmasol (500ml)

• I/V stat @20 d/m 

If severe pain:

inj.Pethedine (50mg)

• 1 ample I/M STAT

Plus 

Inj.Vergon (12.5mg)

• 1 ample I/M stat 

Obstretics mx:

If concealed type:

• ARM +_  Oxytocin then no respose plus fetal distress then C/S

If Revealed type: 

• Patient in labour:  ARM +- Oxytocin 
• Patients no labour : 
• > 37 Weeks : ARM +- Oxytocin 
• < 37 weeks : 
• continue bleeding then ARM +- Oxytocin 
• if bleeding stop & fetus alive then pregnanacy continue upto 37 weeks.