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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