This protocol addresses chronic placental abruption presenting as recurrent episodes of light to moderate vaginal bleeding — a pattern distinct from the sudden haemorrhage of acute abruption and one that requires its own management approach.
Acute abruption is characterized by the sudden onset of vaginal bleeding. Chronic abruption, by contrast, is characterized by recurrent episodes of light to moderate vaginal bleeding. Recognising the chronic pattern is essential before any management decision is made.
Management centres on a defined delivery timing strategy tied to gestational age, with specific provisions for how fetal heart rate findings can alter that plan — the full protocol is available below.
DOI: 10.1016/j.ajog.2022.06.059
Acute abruption is characterized by the sudden onset of vaginal bleeding, and chronic abruption is characterized by recurrent episodes of light to moderate vaginal bleeding.
In our opinion, it is reasonable to deliver pregnant patients with chronic abruption during the 36th and 37th weeks of gestation.
The development of any FHR abnormalities in chronic cases should be an indication for delivery in all near-term or term gestations.
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