Placental Abruption in a Live Fetus with Category III Fetal Heart Rate Pattern

This protocol covers the management of placental abruption when the fetus remains alive but exhibits a category III fetal heart rate (FHR) pattern — including terminal bradycardia or a sinusoidal pattern — without intrauterine fetal death.

Acute abruption is an important contributor to category III FHR patterns. Terminal bradycardia and sinusoidal FHR changes in the setting of placental abruption define a time-critical obstetric emergency requiring immediate action.

Approach (partial overview)

The approach involves maternal stabilization followed by urgent surgical delivery — the complete protocol, decision criteria, and full management algorithm are available via the link below.

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References

DOI: 10.1016/j.ajog.2022.06.059 Several studies have suggested that acute abruption is an important contributor to category III FHR patterns because of terminal bradycardia and sinusoidal FHR patterns. Because of the severe abruption with FHR changes, the patient subsequently underwent urgent cesarean delivery, which was notable for bloody amniotic fluid and complete placental separation. View source ↗