Obgyn: Placental Abruption: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Placental Abruption🎧 A clear, high-yield breakdown of this life-threatening pregnancy complication – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• Premature separation of the placenta from the uterine wall before delivery• Can lead to fetal hypoxia and maternal haemorrhage – an obstetric emergency📌 Causes & Risk Factors• Previous abruption (strongest risk)• Hypertension & pre-eclampsia• Abdominal trauma (e.g. RTA, IPV)• Smoking, cocaine/amphetamine use• Multiple pregnancy• Advanced maternal age, polyhydramnios, uterine abnormalities🧠 Mnemonic: "HARMED"(Hypertension, Age, Rupture/trauma, Multiple pregnancy, Eclampsia, Drugs)📌 Pathophysiology• Placenta detaches → maternal bleeding + ↓ fetal oxygen• Can be concealed (bleeding trapped inside) or revealed (external bleeding)• "Woody" uterus from concealed blood collection📌 Symptoms• Constant abdominal pain• Vaginal bleeding (may be minimal)• Uterine tenderness & hypertonicity• Fetal distress or absent fetal heart• Maternal shock (may appear out of proportion)🧠 Classic Clue: Painful bleeding + firm uterus + CTG changes📌 Differential Diagnosis• Placenta previa (painless bleed)• Uterine rupture• Vasa previa• Cervical pathology📌 Diagnosis• Clinical diagnosis – don’t delay treatment for tests• CTG: signs of fetal hypoxia• Ultrasound: may show retroplacental clot but not reliable• Bloods: FBC, clotting, crossmatch💡 BP may be normal despite heavy bleeding – beware compensation📌 Management• Resuscitate mother first (ABC + left lateral position)• 2x wide-bore cannulas, oxygen, fluids, blood products (FFP, cryoprecipitate)• Immediate delivery if fetal distress or maternal instability• Vaginal delivery if fetus has demised (unless maternal risk dictates CS)• Corticosteroids if <36 weeks and stable🔑 Clinical judgment > investigations📌 Complications• Maternal: PPH, DIC, shock, renal failure, hysterectomy• Fetal: IUGR, preterm birth, stillbirth, cerebral palsy📌 Prognosis• 11.9% perinatal mortality vs 0.8% in unaffected pregnancies• Prognosis depends on severity, speed of intervention, and fetal viability📎 More MSRA Resources for Placental Abruption📝 Revision Notes: https://www.passthemsra.com/topic/placental-abruption-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/placental-abruption-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/placental-abruption-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/placental-abruption-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/obstetrics-and-gynaecology-for-the-msra/#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #PlacentalAbruption #ObstetricsAndGynaecology