PATHOPHYSIOLOGY

PLACENTAL ABRUPTIO
ABRUPTIO PLACENTA
WITH DIC
EXTRINSIC and INTRINSIC PATHWAY
EF:(Involves Tissue Factor, factor VIIaand X and Ca2)

IF: (Xa, XII, XI, IX, VIII, X, PREKALLIKREIN, CA2, PHOSPHATIDYLSERINE)

FORMATION OF FIBRIN- RESPONSIBLE FOR BLOOD CLOTTING

In DIC, the clotting factors were overwhelmed than normal

To compensate for the excess formation of blood clotting factor,

Plasmin will be produced, an enzyme responsible for clot
breakdown, plasminogen to plasmin through catalization
by serine protase
Plasminogen-Plasmin

ACCELERATED
FIBRINOLYSIS

BLEEDING!!!
(the bleeding in Abruptio placenta is already occurring at the very start, but it
was not dismissed even after coagulation because of instability of fibrinolytic system of the
body. Why still bleeding? Since the blood clotting factors was all used up, it will result to
continuous bleeding
Placental abruption- occurs when the placenta separates from the uterus before the birth of the baby.

- Possible cause,
older age of the mother,history of placental abruption during a previous pregnancy,
high blood pressure, diabetes, collagen vascular diseases,
uterine tumor called a leiomyoma, twins, triplets, or other multiple pregnancies,
cigarette smoking,heavy alcohol use, cocaine use, malformations of the uterus,
malformations of the placenta, injury to the abdomen

DIC (Disseminated Intravascular Coagulation)-Causes blood to clot excessively that reduce blood flow and can
block blood from reaching body organ. As the condition progresses, the platelets and clotting factors in the
blood are used up, and they will begin excessive bleeding.

-Instability of fibrinolytic system further contributes to intravascular clot formation, but in some cases,
accelerated fibrinolysis may cause severe bleeding. Hence, the patient with disseminated intravascular
coagulation (DIC) can present with a simultaneously occurring thrombotic and bleeding problem.

-DIC is not a specific illness; rather it is a complication or an effect of the progression of other
illnesses. It is secondary to underlying disorder which includes Obstetric complication- Amniotic embolism,
ABRUPTIO PLACENTAE.

-Dysfunctional physiologic anticoagulant mechanism (eg. Depression of antithrombin and protein C

system, which cannot adequately balance this thrombin generation)