Comparison of Placental Abruption, Placenta Previa, and Uterine Rupture

 

Feature Placental Abruption Placenta Previa Uterine Rupture
Signs and Symptoms

 

– Onset Sudden Often gradual Sudden
– Bleeding Vaginal bleeding (usually dark) Painless bright red vaginal bleeding Vaginal bleeding
– Pain Severe abdominal pain Usually, painless Severe abdominal pain
– Uterine Activity Uterine tenderness, contractions/increased uterine tone Uterus soft and relaxed Loss of uterine tone
– Foetal Distress Foetal distress is common Foetal distress is less common Foetal distress is common
Investigations

 

– Initial Investigation Cardiotocography (CTG) Ultrasound (preferably transvaginal) Cardiotocography (CTG)
– Follow-up Investigation Vaginal ultrasound (if CTG normal) None, ultrasound is definitive Ultrasound or MRI for diagnosis
Management

 

– Immediate Actions Perform CTG, if foetal distress urgent C-section Avoid digital or speculum exam until placenta previa is ruled out Perform CTG, immediate surgical intervention if confirmed
– Definitive Treatment Urgent C-section if foetal distress; stabilize mother Planned C-section if diagnosed; emergency C-section if bleeding Emergency surgical repair or C-section
– Monitoring Continuous foetal monitoring Continuous foetal monitoring Continuous foetal monitoring
– Blood Loss Management Manage blood loss and stabilize maternal hemodynamic Blood transfusion if necessary Manage blood loss and stabilize maternal hemodynamic