Biju Nivedita, Backer Corinne
Obstetrics and Gynecology, A.T. Still University, Saint Louis, USA.
Obstetrics and Gynecology, Mercy Health, Saint Louis, USA.
Cureus. 2025 May 4;17(5):e83469. doi: 10.7759/cureus.83469. eCollection 2025 May.
Placental abruption is a life-threatening obstetric emergency, often associated with hypertensive disorders such as preeclampsia. This study describes a 28-year-old multiparous woman at 36 weeks and four days of gestation who presented with contractions without any overt signs of preeclampsia. Despite an initial blood pressure of 130/85 mmHg, fetal bradycardia and uterine tachysystole prompted an emergency cesarean section. Intraoperative findings confirmed placental abruption, and postoperative laboratory results revealed significant proteinuria, confirming undiagnosed preeclampsia. Postpartum complications included severe hemorrhage exceeding 2000 mL, progressing to disseminated intravascular coagulation (DIC), which required aggressive resuscitation, a massive transfusion protocol, and intensive care management. This case emphasized the challenge of diagnosing "hidden" preeclampsia, the variability of placental abruption presentations, and the importance of early recognition and intervention. Clinicians should maintain a high index of suspicion for atypical presentations of preeclampsia to mitigate adverse maternal and fetal outcomes.
胎盘早剥是一种危及生命的产科急症，常与子痫前期等高血压疾病相关。本研究描述了一名28岁经产妇，妊娠36周零4天时出现宫缩，但无明显子痫前期迹象。尽管初始血压为130/85 mmHg，但胎儿心动过缓和子宫收缩过频促使进行急诊剖宫产。术中发现证实为胎盘早剥，术后实验室检查结果显示大量蛋白尿，确诊为未诊断出的子痫前期。产后并发症包括严重出血超过2000 mL，进展为弥散性血管内凝血（DIC），这需要积极复苏、大规模输血方案和重症监护管理。该病例强调了诊断“隐匿性”子痫前期的挑战、胎盘早剥表现的变异性以及早期识别和干预的重要性。临床医生应对子痫前期的非典型表现保持高度怀疑，以减轻母婴不良结局。
