Premature Placental Abruption: assessment of risk factors, diagnosis, and therapeutic approaches

Abstract

Pregnancy is generally a natural and uncomplicated process, but some pregnancies are considered high-risk due to specific complications, such as prenatal hemorrhages, including miscarriage, placenta previa, and premature placental abruption (PPA). Prenatal hemorrhage poses a significant risk to both the mother and the fetus, with the fetus being particularly vulnerable. Approximately 90% of pregnancies are low-risk, but those with complications are classified as high-risk. PPA, a severe condition associated with high maternal and fetal morbidity and mortality, is characterized by the premature separation of the placenta from the uterus before birth. Clinical signs include severe abdominal pain, variable bleeding, uterine hypertonia, and fetal distress. The etiology is multifactorial, involving factors such as vascular abnormalities, hypertension, drug use, among others. Diagnosis is primarily clinical, supported by complementary tests. Management includes early delivery, vigorous volume replacement, and constant monitoring. The approach varies according to the severity of the case and gestational age, potentially involving vaginal delivery or cesarean section.