Abruptio Placenta for Certified Emergency Nursing (CEN)

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Outline

Abruptio Placenta

 

Definition/Etiology:

  • Placental separation from uterine wall
    • Rupture of arterial vessels
    • Major cause of obstetric hemorrhage, hypovolemic shock
    • Inhibits supply of oxygen, nutrients to fetus
    • Most common cause of fetal demise from maternal trauma

 

Clinical Presentation:

  • Backache, painful contractions, abdominal pain
  • Uterine rigidity
  • Frank, dark-red vaginal bleeding or concealed bleeding
  • Maternal hemorrhagic shock
  • Coagulation panel, elevated D-dimer, decreased platelets
  • Abnormal fetal heart tones

 

Collaborative Management:

Assessment-

  • Urgent obstetric consult
  • CBC, type and crossmatch with Rh
  • Continuous electronic fetal heart monitoring

Interventions-

  • Transport to tertiary center if appropriate; or to obstetrics
  • High-flow supplemental oxygen
  • Fluid resuscitation and transfusion
  • Emergent delivery

Linchpins: (Key Points)

  • Placental separation from uterine wall
  • Urgent obstetric consult
  • Fetus is deprived of needs
    • Call Specialist!!!

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Transcript

For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/

References:

  • Emergency Nurses Association. (2017) Emergency Nursing Core Curriculum, 7th Edition. PA: Saunders
  • Savone, D. (2017). Genitourinary, Gynecology, and Obstetrical Emergencies. In CEN Online Review. Emergency Nurses Association.

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