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Dr Wael El Banna: How A Retroplacental Hematoma Looks Like In A Surgery Room
Dr Wael El Banna/LinkedIn
Oct 5, 2025, 08:30

Dr Wael El Banna: How A Retroplacental Hematoma Looks Like In A Surgery Room

 

Dr Wael El Banna, OBGYN Consultant at FertiClinic Fertilization Group, Owner of ElBanna Group, posted on LinkedIn:

”How a retroplacental hematoma looks like in a surgery room. (watch that video )

The key management steps are :

Immediate Resuscitation and Multidisciplinary Care

  • Initial focus is on maternal resuscitation following the ABC approach: airway, breathing, and circulation.
  • Management should be according to locally-created massive obstetric hemorrhage protocols, led by a senior obstetrician, anesthetist, haematologist, and the midwifery team, with laboratory and portering staff alerted.
  • Bloods should be immediately sent for blood grouping, crossmatch, full blood count, and coagulation screen, with 4 units of crossmatched blood prepared.
  • Senior and experienced staff should be involved as early as possible in both obstetric and anaesthetic roles.

Management of Coagulopathy

  • Disseminated intravascular coagulation (DIC) can develop rapidly in massive abruption; urgent clotting studies and platelet count are necessary.
  • Up to 4 units of fresh frozen plasma (FFP) and 10 units of cryoprecipitate can be administered empirically if relentless bleeding persists while awaiting test results.
  • Haematology input is vital for guiding further transfusions and clotting factor support.

Delivery

  • If maternal or fetal compromise is evident, immediate delivery is required.
  • Mode of delivery depends on fetal and maternal status:
  • If fetal death has occurred and maternal condition is stable, vaginal delivery is generally recommended.
  • If fetus is alive but compromised, expedite delivery by caesarean section, unless vaginal delivery is imminent.

Additional Considerations

  • Continuous maternal and fetal monitoring is essential during and after the acute event.
  • All RhD-negative women should receive anti-D immunoglobulin if more than 20 weeks gestation.
  • Ongoing monitoring for PPH, renal dysfunction, and further coagulopathy is needed post-delivery.
  • If the patient develops hypovolemia or shock, ICU-level support and ongoing multidisciplinary care are mandatory.”

 

 

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Coagulopathy Dr Wael El Banna ElBanna Group FertiClinic Fertilization Group Gynecology Health Hematology Hemostasis Hemostasis Today Medicine Obstetrics Retroplacental Hematoma thrombosis
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