Placental Abruption as a Complication of Preeclampsia that Causes Fetal Distress

Indra Hapdijaya, Ecclesia Tessalina, Elisabeth Mariska Natasha Herdiana, Janice Natalia, G. D. Brata, Hendrik Andrianto, Catharine Welanai Jemarut, Livia Devina, Aloysius Suryawan
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Abstract

Background Placental abruption is a common complication of preeclampsia. It is an obstetric emergency which occurs when the placenta partially or completely separates from the uterine wall. The diagnosis is usually made clinically or objectively. It is relatively rare but put a serious risk for both the fetus and the mother. Case presentation We reported a case of a 32-year-old multigravida patient at 35-36 weeks gestation presented with moderate vaginal bleeding and lower abdominal pain. Her obstetric history included one premature vaginal delivery. Her blood pressure started to rise in the second trimester of pregnancy. The examination revealed that her blood pressure was 190/120 mmHg, she had pitting edema on her extremities and tender uterine fundus. The fetal heart rate was bradycardia at 100 beats per minute. Placental abruption and fetal distress were diagnosed. An emergency cesarean section was performed. Intraoperatively, the uterus showed intramural bleeding and was livid, with the beginning of Couvelaire-uterus. The uterus was left in situ. Conclusion As a conclusion, placental abruption interrupts the vital function of the placentae which leads to fetal hypoxia and even fetal death. It is an obstetric emergency that requires immediate intervention to save the fetus and reduce the risk of complications in the mother.
胎盘早剥是子痫前期引起胎儿窘迫的并发症
背景:胎盘早剥是子痫前期常见的并发症。这是一种产科急诊,发生在胎盘部分或完全从子宫壁分离时。诊断通常是临床或客观作出的。这是相对罕见的,但对胎儿和母亲都有严重的风险。我们报告了一例32岁的多胎妊娠患者在妊娠35-36周表现为中度阴道出血和下腹部疼痛。她的产科史包括一次阴道早产。她的血压在妊娠中期开始升高。检查发现患者血压190/120 mmHg,四肢凹陷性水肿,子宫底压痛。胎儿心率为心动过缓,每分钟100次。诊断为胎盘早剥和胎儿窘迫。进行了紧急剖宫产手术。术中子宫壁内出血,呈青色,开始出现库夫莱尔-子宫。子宫留在原位。结论胎盘早剥可中断胎盘的生命功能,导致胎儿缺氧甚至死亡。这是一种产科急诊,需要立即进行干预以挽救胎儿并降低母亲并发症的风险。
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