Management

The management of abruptio placentae is primarily supportive and entails both aggressive hydration and monitoring of maternal and fetal well-being, with the expeditious delivery of the fetus if indicated (Turner, 1994). Maternal and fetal death may result from hemorrhage and coagu-lopathy. Coagulation studies should be performed to look for disseminated intravascular coagulation (DIC). Packed RBCs should be typed and held. If the fetus appears viable but compromised, urgent cesarean delivery should be considered. Recommended laboratory testing includes complete blood count with platelets, prothrombin and partial thromboplastin time, fibrinogen, fibrin degradation products, D-dimer, blood type, and Kleihauer-Betke acid elution. D(Rh)-negative mothers benefit from administration of D immune globulin (Pearlman et al., 1990).

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