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Sensitivity and reliability of ultrasound is poor for detecting or excluding placental abruption as clinically significant abruption most of the time shows negative sonographic findings. However, these signs are not always present and absence of these does not exclude the diagnosis.
Patients with placental abruption most commonly present with the triad of abdominal pain, abnormal uterine tenderness and vaginal bleeding. The classic, clinical hallmark is vaginal bleeding, which may be present in upto 80% to 90% of cases.
Abruption is confirmed after placental delivery by evaluation of the retroplacenal clots or a depression in the maternal surface of placenta. The diagnosis of placental abruption is clinical, based on characteristic signs and symptoms. Incidence of placental abruption is 1% in singleton pregnancies, while its incidence is almost doubled in twin gestations and it is more common in third trimester of pregnancy, although the process may occur earlier in gestation. It occurs in approximately 1 in 80 deliveries. The term ‘abruptio placentae’ literally means ‘rending as under of the placenta’ which denotes a sudden accident that is a clinical characteristic of most of the cases. Placental abruption has been defined as the complete or partial separation of the normally located placenta from its uterine site before the delivery of the foetus.