Placental Abruption

Definition

Placental abruption occurs when the placenta separates from the uterus before the fetus is delivered. The placenta is the organ that provides nourishment for the fetus while it is still in the uterus. In a healthy pregnancy, the placenta remains attached to the uterine wall until after the fetus is delivered.

Some form of the condition affects about one in every 150 births. In very severe forms, placental abruption can cause death to the fetus. This is uncommon. Death of the mother from placental abruption is very rare.

Placental abruption can cause:

• Premature delivery
• Fetal anemia
• Low birth weight
• Significant blood loss for the mother
• Fetal death

Placental Abruption

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Causes

The direct cause of placental abruption is not clearly understood. It may be a combination of several events. These may include:

• Impaired formation and structure of the placenta
• Low oxygen levels inside the uterus
• Rupture of a uterine artery or vein which causes bleeding between the placenta and the uterine wall
• Injury to the abdomen from an accident or a fall
• Sudden decrease in the volume of the uterus, from significant loss of amniotic fluid or from the delivery of a first twin

Risk Factors

Factors that may increase your chance of placental abruption:

• Previous placental abruption in a prior pregnancy
• High blood pressure during pregnancy—pre-eclampsia
• Pregnancy during older age
• Multiple previous deliveries
• Excessively distended uterus
• Smoking during pregnancy
• Drug misuse, especially cocaine

Symptoms

In the early stages, you may not have symptoms. When symptoms occur, they may include:

• Vaginal bleeding
• Abdominal pain
• Back pain
• Rapid contractions
• Soreness in the uterus
• Feeling faint
• Baby moving less

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. A pelvic exam will also be done to examine your reproductive organs.

Tests may include:

• Ultrasound
• Blood coagulation profile to determine how long it takes for your blood to clot

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Intravenous Treatments

Fluids may be given by IV to replace lost fluids. Blood transfusions may also be given to replace lost blood supply.

You and your fetus will be carefully monitored for signs of distress or shock, including abnormal heart rates.

Emergency Cesarean Delivery

If danger exists fyour or your fetus, an emergency cesarean section may be done. If both you and your fetus are at low risk of complications and your fetus is full-term, the you may deliver vaginally.

Prevention

To help reduce your chance of placental abruption:

• Avoid taking drugs and smoking during pregnancy.
• Receive proper and regular prenatal care throughout your pregnancy.
• Promptly treat conditions, such as high blood pressure.