Abruptio Placenta Full

INTRODUCTION Placental abruption (also known as abruptio placentae) is an obstetric catastrophe (complication of pregnancy), wherein the placental lining has separated from the uterus of the mother. It is the most common cause of late pregnancy bleeding. In humans, it refers to the abnormal separation after 20 weeks of gestation and prior to birth. It occurs in 1% of pregnancies world wide with a fetal mortality rate of 20-40% depending on the degree of separation. Placental abruption is also a
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  INTRODUCTIONPlacental abruption (also known as abruptio placentae) is an obstetric catastrophe (complicationof pregnancy), wherein the placentallining has separated from theuterusof themother . It is the most common cause of late pregnancy bleeding. In humans, it refers to the abnormal separationafter 20 weeks of gestation and prior to birth. It occurs in 1% of  pregnanciesworld wide with afetal mortality rate of 20-40% depending on the degree of separation. Placental abruption is alsoa significant contributor to maternal mortality. Many women can die from this type of abnormality. The heart rate of the fetus can be associated with the severity.Placental abruption is suspected when a pregnant mother has sudden localized abdominal painwith or without bleeding. Thefundusmay be monitored because a rising fundus can indicate bleeding. An ultrasound may be used to rule out placenta praevia but is not diagnostic for abruption. The mother may be givenRhogamif she isRh negative. Treatment depends on the amount of blood loss and the status of the fetus. If the fetus is less than36 weeks and neither mother or fetus are in any distress, then they may simply be monitored inhospital until a change in condition or fetal maturity whichever comes first.Immediate delivery of the fetus may be indicated if the fetus is mature or if the fetus or mother are in distress. Blood volume replacement and to maintain blood pressure and blood plasma replacement to maintain fibrinogen levels may be needed. Vaginal birth is usually preferred over caesarean sectionunless there is fetal distress. Caesarean section is contraindicated in cases of disseminated intravascular coagulation. Patient should be monitored for 7 days for PPH.Excessive bleeding from uterus may necessitate hysterectomy if family size is completed.PATIENT PROFILE ã Ward: MCM-DR  ã Date of Admission: May 23, 2010 ã Patients Name: B.C. ã Address: Pandacan. ã Age: 35 years old ã Gender: Female ã Birth Date: November 15, 1975 ã Educational status: High school undergraduate ã Religion: Roman Catholic ã  Nationality: Filipino ã Civil Status: Married ã Occupation:Housewife ã Health Care Financing: Phil Health ã Informant: Patient ã Reliability: 100%ANATOMY AND PHYSIOLOGY  Female Reproductive SystemMost species have 2 sexes: male and female. Each sex has its own unique reproductive system.They are different in shape and structure, but both are specifically designed to produce, nourish,and transport either the egg or sperm.Unlike the male, the human female has a reproductive system located entirely in the pelvis. Theexternal part of the female reproductive organs is called the vulva, which means covering.Located between the legs, the vulva covers the opening to the vagina and other reproductiveorgans located inside the body.The fleshy area located just above the top of the vaginal opening is called the mons pubis. Two pairs of skin flaps called the labia (which means lips) surround the vaginal opening. The clitoris,a small sensory organ, is located toward the front of the vulva where the folds of the labia join.Between the labia are openings to the urethra (the canal that carries urine from the bladder to theoutside of the body) and vagina. Once girls become sexually mature, the outer labia and themons pubis are covered by pubic hair.A female's internal reproductive organs are the vagina, uterus, fallopian tubes, and ovaries.The vagina is a muscular, hollow tube that extends from the vaginal opening to the uterus. Thevagina is about 3 to 5 inches (8 to 12 centimeters) long in a grown woman. Because it hasmuscular walls, it can expand and contract. This ability to become wider or narrower allows thevagina to accommodate something as slim as a tampon and as wide as a baby. The vagina'smuscular walls are lined with mucous membranes, which keep it protected and moist. The vaginaserves 3 purposes: It's where the penis is inserted during sexual intercourse, and it's also the pathway that a baby takes out of a woman's body during childbirth, called the birth canal, and it provides the route for the menstrual blood (the period) to leave the body from the uterus.A thin sheet of tissue with 1 or more holes in it called the hymen partially covers the opening of the vagina. Hymens are often different from person to person. Most women find their hymenshave stretched or torn after their first sexual experience, and the hymen may bleed a little (thisusually causes little, if any, pain). Some women who have had sex don't have much of a changein their hymens, though.The vagina connects with the uterus, or womb, at the cervix (which means neck). The cervix hasstrong, thick walls. The opening of the cervix is very small (no wider than a straw), which is whya tampon can never get lost inside a girl's body. During childbirth, the cervix can expand to allowa baby to pass.The uterus is shaped like an upside-down pear, with a thick lining and muscular walls - in fact,the uterus contains some of the strongest muscles in the female body. These muscles are able toexpand and contract to accommodate a growing fetus and then help push the baby out duringlabor. When a woman isn't pregnant, the uterus is only about 3 inches (7.5 centimeters) long and2 inches (5 centimeters) wide.At the upper corners of the uterus, the fallopian tubes connect the uterus to the ovaries. Theovaries are 2 oval-shaped organs that lie to the upper right and left of the uterus. They produce,  store, and release eggs into the fallopian tubes in the process called ovulation. Each ovarymeasures about 1 1/2 to 2 inches (4 to 5 centimeters) in a grown woman.There are 2 fallopian tubes, each attached to a side of the uterus. The fallopian tubes are about 4inches (10 centimeters) long and about as wide as a piece of spaghetti. Within each tube is a tiny passageway no wider than a sewing needle. At the other end of each fallopian tube is a fringedarea that looks like a funnel. This fringed area wraps around the ovary but doesn't completelyattach to it. When an egg pops out of an ovary, it enters the fallopian tube. Once the egg is in thefallopian tube, tiny hairs in the tube's lining help push it down the narrow passageway toward theuterus.The ovaries are also part of the endocrine system because they produce female sex hormonessuch as estrogen and progesterone. Normal Placenta During ChildbirthProcess of placental growth and uterine wall changes during pregnancy1.The placenta grows with the placental site during pregnancy.2.During pregnancy and early labor the area of the placental site probably changeslittle, even during uterine contractions. 3. The semirigid, noncontractile placenta cannot alter its surface area.Anatomy of the uterine/placental compartment at the time of birth 1. The cotyledons of the maternal surface of the placenta extend into the decidua basalis,which forms a natural cleavage plane between the placenta and the uterine wall.2.There are interlacing uterine muscle bundles, consisting of tiny myofibrils, around the branches of the uterine arteries that run through the wall of the uterus to the placentalarea.3.The placental site is usually located on either the anterior or the posterior uterine wall.4.The amniotic membranes are adhered to the inner wall of the uterus except where the placenta is located.PATHOPHYSIOLOGY  DIAGNOSTIC/LABORATORYHgb- 
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