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PubMed1998

Abruptio placentae.

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Abruptio Placentae↗
PubMed2006

Abruptio placentae during fetal myelomeningocele repair.

Myelomeningocele (MM) is a congenital neural tube defect with serious consequences, including hydrocephaly. An important hope for intrauterine repair is that hydrocephaly may be prevented by reversing the Arnold-Chiari malformation. Three medical centers in the United States are doing trials with this objective. We describe an intrauterine correction of MM in a Brazilian research center of fetal medicine, which resulted in abruptio placentae and fetal death, to illustrate factors that influence fetal-maternal risks during this surgical procedure.

Abruptio Placentae↗
PubMed2002

Tetany following resuscitation after abruptio placentae.

BACKGROUND: Serum ionized calcium and magnesium are normally decreased during later stages of pregnancy. A further rapid decline may be caused by the rapid infusion of blood bank products in which citrate is used as an anticoagulant/preservative. Tetany, as reported here, may be precipitated by such infusions. CASE: A gravid woman presented in hemorrhagic shock due to abruptio placentae. Rapid infusion of packed red blood cells and fresh frozen plasma precipitated signs of tetany, muscle rigidity, posturing, high airway pressure during mechanical ventilation, etc. Ionized calcium and magnesium blood levels were very low (0.58 mmol/L and 1.0 mg/dL, respectively), but responded to rapid electrolyte administration. CONCLUSION: Binding of calcium and magnesium by citrate may lead to hypo-ionized calcemic and hypomagnesemic tetany after rapid replacement of blood products in the pregnant patient. This consequence is worsened when extreme alkalemia due to respiratory or metabolic causes is also present.

Abruptio Placentae↗
PubMed1978

[Clinical studies on the connection between preceding abruptio placentae and abortus and subsequent complications during the afterbirth phase (author's transl)].

2176 vaginal deliveries at Jena University Hospital were selected at random to check whether in these patients it is possible to establish the connection postulated by some authors between preceding premature termination of pregnancy and the mass incidence of afterbirth haemorrhages, as well as of necessary surgery in the afterbirth phase. There was no significant increase of afterbirth complications following abruptio placentae and abortus, whereas there are partly statistically significant differences in the incidence of surgery reauired in children of normal weight of underweight.

Abortion, Spontaneous↗
PubMed1976

Proteinuria and the renal lesion in preeclampsia and abruptio placentae.

The defect in glomerular permeability that leads to proteinuria can be assessed by determining the relative clearance of macromolecules of known but different dimensions, that is, glomerular selectivity. Such estimates can be made using naturally occurring plasma proteins and dextran or polyvinylpyrrolidone injected into the circulation. In preeclampsia, protein and dextran selectivities show good concordance. The proteinuria is intermediate in its selectivity. These findings confirm that proteinuria is glomerular in origin and that the glomerular abnormality is uniform throughout the majority of functioning glomeruli. In abruptio, protein selectivity is very low and dextran selectivity is high. This pattern is seen also in acute ischemic renal failure and suggests that the true glomerular functional defect is actually less severe than in preeclampsia and that much of the protein in the urine in abruptio is postglomerular in origin. The structural lesion in preeclampsia is "characteristic" only in the sense that a number of individual components of glomerular injury, which are themselves commonly seen in other glomerular disorders, occur in a particular balance, and not because of any single unique or specific feature. The important components--that is, endothelial swelling, mesangial cytoplasmic activity, subendothelial deposits, and occational thrombosis of the afferent arterioles--all occur, albeit to a lesser degree, in abruptio placentae, as well as in other glomerular disorders in which intravascular coagulation is a primary cause or plays a major role.

Abruptio Placentae↗
PubMed1991

Cocaine abuse is associated with abruptio placentae and decreased birth weight, but not shorter labor.

Many of our patients report having ingested cocaine hoping to decrease the duration of labor. We reviewed the computerized records of 592 women who abused cocaine. Compared with 4687 controls, women who ingested cocaine were older and had higher parity. Birth weight, birth weight percentile, and gestational age at delivery were significantly decreased among their neonates, and the incidence of abruptio placentae was nearly doubled among these women. Although these factors tend to shorten labor, the total duration of labor was not significantly different between the two groups. These data add to the accumulating evidence that cocaine abuse is associated with increased obstetric morbidity, but do not support the belief that cocaine shortens labor.

Abruptio Placentae↗
PubMed2000

Fetal death from abruptio placentae associated with incorrect use of a seatbelt.

A female driver, 24 weeks pregnant, was wearing a three-point seatbelt in the manner usual for nonpregnant women, when her automobile collided head-on with another vehicle. A cardiotocographic examination after the accident revealed the fetus to be alive. Five days after the accident, however, a cardiotocographic examination showed fetal death. At that time, a transverse ecchymotic band on the lower abdominal wall that had not been observed at the first examination was noticed. Eight days after the accident, the mother delivered a macerated female fetus. At autopsy, the baby showed no abnormality, but there was a hematoma on the placental surface toward the uterus. These results suggest that the fetus died of abruptio placentae associated with incorrect placement of the lap belt.

Abruptio Placentae↗
PubMed1980

Isolation of fibrinogen-fibrin related antigen from human plasma by immuno-affinity chromatography: its characterization in normal subjects and in defibrinating patients with abruptio placentae and disseminated cancer.

Highly purified fibrinogen-fibrin related antigen (FR-antigen) was isolated with good recovery from 1.0--2.0 ml of human plasma, by immuno-affinity chromatography with antibody specific for fibrinogen and fibrin, and plasmin degradation products X, Y, D and D-D dimer. In FR-antigen from defibrinating patients there was evidence for thrombin activity alone (mainly disseminated cancer) or both plasmin and thrombin (mainly abruptio placentae). Thus, the molar ratio of N-terminal Gly-Tyr in the FR-antigen of 18 of 20 patients strongly suggested thrombin activity (95th percentile). In addition, sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) on unreduced samples frequently showed bands similar in mol wt to fragments X, Y and D, and in the reduced samples A alpha and B beta chain degradation, both indicating plasmin activity. 'N-terminal beta chain Ala' was elevated in the antigen of four of 20 patients, also suggesting plasmin activity (99th percentile). Combined thrombin, plasmin and factor-XIII activity, as shown with high levels of serum FR-antigen (greater than 10 mg/dl). In some defibrinating patients, especially those with disseminated cancer, heterogeneity of unreduced FR-antigen and A alpha chain degradation, both indicators of mild plasmin-like activity which are commonly seen in normals, were absent.

Abruptio Placentae↗
PubMed1997

Spontaneous rectus sheath hematoma during pregnancy mimicking abruptio placenta.

Sudden disruption of a deep epigastric vessel may result in an abdominal wall hematoma, which, depending upon its location and size, can produce symptoms and clinical findings compatible with a variety of acute intra-abdominal conditions. The literature has noted a predominance of pregnant patients among those affected with this malady. Such hematomas are infrequently encountered and early accurate diagnosis could prevent surgical intervention. Unfortunately, the clinical manifestations of rectus muscle hematoma are sometimes so dramatic that laparotomy is performed under the belief that intra-abdominal pathology is present. We present a case of a suspected abruptio placenta misdiagnosed by clinical and ultrasound examination that was subsequently discovered to be a rectus sheath hematoma at the time of surgery.

Abdomen, Acute↗
PubMed1994

Abruptio placentae and disseminated intravascular coagulation: use of thrombelastography and sonoclot analysis.

We report a case in which thrombelastography (TEG) and Sonoclot analysis were used for diagnosis and treatment decisions in a patient with abruptio placentae and disseminated intravascular coagulation. In addition to providing enough information for evaluation and treatment of this patient, the TEG and Sonoclot results were obtained more quickly, with smaller blood samples and with less expense to the patient in comparison to the standard coagulation tests in our institution. Although the TEG and Sonoclot results were assessed independently of the other test and each provided similar information in this case, the TEG may be the preferred tool in evaluating coagulopathies, based on computerization and strong literature support.

Journal Article↗