Placenta Abruptio
Placenta Abruptio
Placenta Abruptio
Placenta abruptio is the separation of the placenta (the organ that nourishes the fetus) from
its attachment to the uterus wall before the baby is delivered.
Causes
The exact cause of a placental abruption may be hard to determine.
Injury to the belly area (abdomen) from a fall, hit to the abdomen, or automobile
accident
Sudden loss of uterine volume (can occur with rapid loss of amniotic fluid or after a
first twin is delivered)
Placental abruption, which includes any amount of placental separation before delivery,
occurs in about 1 out of 150 deliveries. The severe form, which can cause the baby to die,
occurs only in about 1 out of 800 to 1,600 deliveries.
Symptoms
Abdominal pain
Back pain
Frequent uterine contractions
Uterine contractions with no relaxation in between
Vaginal bleeding
Abdominal ultrasound
Complete blood count
Fetal monitoring
Fibrinogen level
Partial thromboplastin time
Pelvic exam
Prothrombin time
Vaginal ultrasound
Treatment
Treatment may include fluids through a vein (IV) and blood transfusions. The mother will
be carefully monitored for symptoms of shock. The unborn baby will be watched for signs
of distress, which includes an abnormal heart rate.
An emergency cesarean section may be needed. If the baby is very premature and there is
only a small placental separation, the mother may be kept in the hospital for close
observation. She may be released after several days if the condition does not get worse.
If the fetus is developed enough, vaginal delivery may be done if it is safe for the mother
and child. Otherwise, a cesarean section may be done.
Outlook (Prognosis)
The mother does not usually die from this condition. However, all of the following increase
the risk for death in both the mother and baby:
Closed cervix
Delayed diagnosis and treatment of placental abruption
Excessive blood loss, leading to shock
Hidden (concealed) uterine bleeding in pregnancy
No labor
Fetal distress occurs early in the condition in about half of all cases. Infants who live have a
40-50% chance of complications, which range from mild to severe.
Possible Complications
Excess blood loss may lead to shock and possible death in the mother or baby. If bleeding
occurs after the delivery and blood loss cannot be controlled in other ways, the mother may
need a hysterectomy (removal of the uterus).
Call your doctor right away if you have bleeding during pregnancy. See your health care
provider right away, call your local emergency number (such as 911), or go to the
emergency room if you are pregnant and have vaginal bleeding and severe abdominal pain
or contractions during your pregnancy. Placental abruption can quickly become an
emergency condition that threatens the life of both the mother and baby.
Prevention
Avoid drinking, smoking, or using recreational drugs during pregnancy. Get early and
regular prenatal care.
Recognizing and managing conditions in the mother such as diabetes and high blood
pressure also decrease the risk of placental abruption.