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Placenta Abruptio

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Placenta abruptio

URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/000901.htm

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.

Direct causes are rare, but include:

 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)

Risk factors include:

 Blood clotting disorders (thrombophilias)


 Cigarette smoking
 Cocaine use
 Diabetes
 Drinking more than 14 alcoholic drinks per week during pregnancy
 High blood pressure during pregnancy (about half of placental abruptions that lead
to the baby's death are linked to high blood pressure)
 History of placenta abruptio
 Increased uterine distention (may occur with multiple pregnancies or very large
volume of amniotic fluid)
 Large number of past deliveries
 Older mother
 Premature rupture of membranes (the bag of water breaks before 37 weeks into the
pregnancy)
 Uterine fibroids

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

Exams and Tests


Tests may include:

 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).

When to Contact a Medical Professional


Call your health care provider if you are in an auto accident, even if the accident is minor.

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.

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