Images in clinical medicine | Volume 36, Article 70, 08 Jun 2020 | 10.11604/pamj.2020.36.70.23441

Atypical presentation of placental abruption

Mounir Moukit, Jaouad Kouach

Corresponding author: Mounir Moukit, Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Hay Riyad, 10100, Rabat, Morocco

Received: 10 May 2020 - Accepted: 28 May 2020 - Published: 08 Jun 2020

Domain: Obstetrics and gynecology

Keywords: Threatened preterm labor, placental abruption, ultrasound

©Mounir Moukit et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Mounir Moukit et al. Atypical presentation of placental abruption. Pan African Medical Journal. 2020;36:70. [doi: 10.11604/pamj.2020.36.70.23441]

Available online at: https://www.panafrican-med-journal.com/content/article/36/70/full

Home | Volume 36 | Article number 70

Images in clinical medicine

Atypical presentation of placental abruption

Atypical presentation of placental abruption

Mounir Moukit1,&, Jaouad Kouach1,2

 

1Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Hay Riyad, 10100, Rabat, Morocco, 2Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco

 

 

&Corresponding author
Mounir Moukit, Department of Obstetrics and Gynecology, Military Training Hospital Mohammed V, Hay Riyad, 10100, Rabat, Morocco

 

 

Abstract

A 25-year-old primigravida with no significant medical history was referred to our department, at 30 weeks´ gestation, for threatened preterm labor. On general examination, the patient was afebrile with normal vital signs. Obstetrical examination revealed fundal height corresponding to gestational age and regular uterine contractions without uterine rigidity. Fetal heart rate was normal. On speculum, the cervix was macroscopically normal without bleeding, amniotic fluid or vaginal discharge. Vaginal examination objectified an open cervix (2cm). Ultrasound scan showed a single live intrauterine fetus in cephalic presentation of 29-30 weeks with oligoamnios. Placenta was anterior and thick with a hyper echoic basal area measuring 8cmx3cm suggestive of placental abruption. Her blood investigations were normal. Under spinal anesthesia, an emergent caesarean section was performed giving birth to a male newborn, weighing 1200g with normal Apgar scores. Macroscopic examination of the placenta confirmed the retro placental clot in maternal surface. The postoperative period was uneventful for patient and the newborn was transferred to neonatal intensive care unit. The highly variable presentation of placental abruption makes the clinical diagnosis difficult. As was in the present case, it should be suspected in any case of unexplained threatened preterm labor. Ultrasound evaluation can play a role in the diagnosis of acute placental abruption especially in those with atypical clinical presentation.

 

 



Figure 1: A) obstetrical ultrasound objectified the retroplacental hematomas (white arrows); B) macroscopic view of the adherent blood clot on maternal surface (white arrows)

 

 

 

 

Images in clinical medicine

Atypical presentation of placental abruption

Images in clinical medicine

Atypical presentation of placental abruption

Images in clinical medicine

Atypical presentation of placental abruption

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Key words

Threatened preterm labor

Placental abruption

Ultrasound

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Atypical presentation of placental abruption