Placental Abruption - Clinical Manifestation

Clinical Manifestation

• Class 0: asymptomatic. Diagnosis is made retrospectively by finding an organized blood clot or a depressed area on a delivered placenta.
• Class 1: mild and represents approximately 48% of all cases. Characteristics include the following:
  • No vaginal bleeding to mild vaginal bleeding
  • Slightly tender uterus
  • Normal maternal BP and heart rate
  • No coagulopathy
  • No fetal distress
• Class 2: moderate and represents approximately 27% of all cases. Characteristics include the following:
  • No vaginal bleeding to moderate vaginal bleeding
  • Moderate-to-severe uterine tenderness with possible tetanic contractions
  • Maternal tachycardia with orthostatic changes in BP and heart rate
  • Fetal distress
  • Hypofibrinogenemia (i.e., 50–250 mg/dL)
• Class 3: severe and represents approximately 24% of all cases. Characteristics include the following:
  • No vaginal bleeding to heavy vaginal bleeding
  • Very painful tetanic uterus
  • Maternal shock
  • Hypofibrinogenemia (i.e., <150 mg/dL)
  • Coagulopathy
  • Fetal death