Placental abruption describes separation of a normally sited placenta from the uterine wall, resulting in maternal haemorrhage into the intervening space

Epidemiology

• occurs in approximately 1/200 pregnancies

Cause - not known but associated factors:

• proteinuric hypertension
• cocaine use
• multiparity
• maternal trauma
• increasing maternal age

Clinical features

• shock out of keeping with visible loss
• pain constant
• tender, tense uterus
• normal lie and presentation
• fetal heart: absent/distressed
• coagulation problems
• beware pre-eclampsia, DIC, anuria