Abruption pattern

[KrnLet]

Hi, I'm new to this site, but have been an L&D RN for almost 4 years. I'm embarrassed to admit this, but I must get an answer!

WHAT IS AN ABRUPTION PATTERN???

I hear nurses say it, and I ask what they're looking at, and they just say, "it looks like an abruption pattern" or "her contractions." Well, that just doesn't help me much! I need more specifics. Can anyone here PLEASE give me more clarification?

TIA!

[adpiRN]

I think contracting A LOT. Like every 1-2 min. I remember that from EFM.

[KrnLet]

So, hyperstim or tachysystole?? Then, fix the problem! Cut off her pit or give a bolus or something. Where's the issue? I just don't get why we have to call something simple something not so simple (instead of, "I need to cut her pit down" it's, "ooh, she's got an abruption pattern!") Really??

[Elvish, BSN, DNP, RN, NP]

My understanding is that it's low-amplitude/high-frequency contractions that sometimes manifest when there's an evolving abruption. The other stuff - increased resting tone, pain, bleeding, etc., are of course also sx, but 'abruption pattern' I've always taken to mean the short, frequent contractions.

[Hushi05]

They can look like rolling hills in someone you don't expect to see very frequent contractions (e.g., no Pitocin).

[NPinWCH]

If you keep in mind that blood acts as an irritant, then it helps to understand what you might see. Yes, the strip has a bit of a hyperstim look to it and might be accompanied by some decreased variability or decels, but early on may not. The uterus may or may not be tender, the uterus can have an increased tone, the patient usually complains of pain even when there are no contractions and there can be bleeding, but again that depends.

I found a couple of pics that do a decent job of showing what it might look like.

[KrnLet]

Ah, Ok. Thanks so much for these responses! :) I get the "strip look" now. I have had a pt come in with the start of an abruption and caught it before it had a terrible outcome (but not based on her strip). Thank GOD the doctor on call believed me when I called him and came immediately over to assess...some wouldn't have.

[RNLaborNurse4U]

I had a strip that she was literally contracting every 30-60 seconds, for 30-60 second durations, for HOURS. Baby was reactive and was a normal tracing the entire time. No vag bleeding. Continuous abdominal pain was her complaint. She was preterm also, prior c/s. After several different tocolytics, and none working, she started complaining of a sharp, burning, continuous pain near her old uterine incision site.

Finally stat sectioned (geeze, thanks Doc, could you have done it a few hours ago?). Uterine window found. No sign of an abruption - but it doesn't mean that there wasn't a fresh one there, just no clot formation yet.

I have also seen a strip where the same thing happened (not a prior c/s though), and the fetal heart rate slowly went down, down, down............bad outcome.