From the Guidelines
To assess for placental abruption, the following labs are recommended:
- Complete Blood Count (CBC) to evaluate for anemia and thrombocytopenia
- Blood type and screen to prepare for potential transfusion
- Coagulation studies, including prothrombin time (PT) and partial thromboplastin time (PTT), to assess for coagulopathy 1
- Fibrinogen level to evaluate for fibrinogen depletion, which is a key predictor of severe postpartum hemorrhage 1
- Liver function tests (LFTs) to assess for liver dysfunction
- Urinalysis to evaluate for proteinuria and hematuria
- Kleihauer-Betke test to detect fetal-maternal hemorrhage, if suspected Additionally, viscoelastic coagulation testing such as thromboelastography or rotational thromboelastometry may be useful in assessing coagulopathy and guiding transfusion management 1. It is essential to note that laboratory testing should not delay treatment, and patients should be managed based on clinical presentation initially 1.
From the Research
Labs Indicated for Placental Abruption
The following labs are indicated to assess for placental abruption:
- Fibrinogen levels: Plasma fibrinogen levels are predictive of further hemorrhage and can be used to guide treatment 2, 3
- Complete blood count (CBC): Including white blood cell count, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) 4, 5
- Coagulation studies: Including rotational thromboelastometry (ROTEM) to assess coagulopathy 2
- Hematocrit: To assess for blood loss and anemia 5
- Blood type and cross-match: To prepare for potential blood transfusion 2, 3
Rationale for Lab Tests
These lab tests are used to: