[Abruptio placentae].
Retroplacental haematoma (RPH) is a complication affecting 0.25 to 0.4% of all pregnancies and 4% of severe PEs. It is of acute onset, usually unpredictable and its symptoms are not specific: Isolated metrorrhagia, foetal distress, uterine hypertonicity. Clinical, biological and sonographic features suggesting a RPH can be early or late. Haemoconcentration and the forming of notches on Doppler examination of the uterus can appear weeks before the event, whereas raised D-Dimers and foetal tachycardia are identified within days of the event. Although Caesarian section reduces the perinatal death rate by 20 to 50% in a setting of RPH with a live foetus, vaginal delivery is indicated in cases of RPH with fetal demise, following the control of haemorrhagic shock, clotting disorders and uterine hypotonicity.
Bohec
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C
Service de gynécologie-obstétrique, CHU de la Cavale-Blanche, 5, boulevard Tanguy-Prigent, 29609 Brest cedex, France.
Collet
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M
D000037:Abruptio Placentae / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000465:Algorithms; D005260:Female; D006801:Humans; D017410:Practice Guidelines as Topic; D011247:Pregnancy