Treatment of Placental Abruption with Intrauterine Fetal Death

Clinical Scenario

This protocol addresses placental abruption occurring in the setting of intrauterine fetal death (IUFD) — a presentation that may not always feature heavy vaginal bleeding, yet represents a clinically severe form of abruption.

Severity Classification

Abruption associated with fetal death should be categorised as a severe abruption regardless of the degree of visible haemorrhage. This presentation is associated with an increased risk of maternal morbidity and warrants close clinical management.

Management Approach (Partial Overview)

Delivery planning in this setting takes individual patient risk factors into account. For certain patients, a surgical delivery route is appropriate when the risks of an alternative approach are judged to be prohibitive. The complete decision criteria and structured regimen are available via the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.ajog.2022.06.059

IUFD
Although some of these cases may not manifest with heavy vaginal bleeding, abruption associated with fetal death should be categorized as severe abruptions that may also be associated with an increased risk of maternal morbidity.
A repeat cesarean delivery may be performed for patients who have risk factors for uterine rupture and in whom the associated risks of trial of labor are perceived to be prohibitive.

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