Asymptomatic, acute, massive abruptio placenta at 30 weeks´’ gestation in a primigravida with no risk factors – clinical presentation and management

Abruptio placentae with no risk factors

Abstract

Abruptio placenta can be a catastrophic event with a high association with adverse maternal and fetal outcomes. We present a case of massive abruptio placenta occurring in a young asymptomatic mother at 30 weeks' gestation. Although electronic fetal monitoring and ultrasound allowed a prompt diagnosis of an 8 x 5 cm retroplacental hematoma, the fetus died at the time of emergency cesarean section. The fetus was intubated and resuscitated, but there was no resuscitation. Histologic examination of the placenta documented thinning and stacked hypercapilarized villi, with syncitial buds and foci of fibrinoid necrosis in the presence of hyaline streaks on both the maternal and fetal sides.