Abruption of the placenta

Description

Abruption of the placenta (abruptio placenta) is a rare but serious complication of pregnancy. The placenta develops in the uterus during pregnancy. Attaches to the wall of the uterus and supplies the baby with nutrients and oxygen.

Placental abruption occurs when the placenta partly or completely separates from the inner wall of the uterus before delivery. This can decrease or block the baby's supply of oxygen and nutrients and cause bleeding in the mother.

Abruption of the placenta often happens suddenly. This is not, endangers both the mother and the baby.

Symptoms

Abruption of the placenta is more likely to occur in the last trimester of pregnancy, especially in the last weeks before the birth. The signs and symptoms of placental abruption include:

  • Vaginal bleeding, although there may not be any
  • Abdominal Pain
  • Back pain
  • Uterine tenderness or rigidity
  • Uterine contractions, which often came one after the other

Abdominal pain and back pain often begins suddenly. The amount of vaginal bleeding can vary a lot, and does not necessarily indicate how much of the placenta separates from the uterus. It is possible to trap the blood inside the uterus, so even with a severe placental abruption, there may be no visible bleeding.

In some cases, the detachment of the placenta develops slowly (chronic detachment of the placenta), that may cause light, intermittent vaginal bleeding. Your baby may not grow as quickly as expected, and you may have little amniotic fluid, or other complications.

When to see a doctor

Seek emergency medical attention if you have signs or symptoms of placental abruption.

Causes

The cause of placental abruption is often unknown. Possible causes include trauma or injury to the abdomen — from a car accident or a fall, for example — or the rapid loss of the fluid that surrounds and protects the baby in the womb (amniotic fluid).

Risk factors

Factors that may increase the risk of abruption of the placenta are:

  • Placental abruption in a previous pregnancy that was not caused by abdominal trauma
  • Chronic high blood pressure (hypertension)
  • Hypertension associated with problems during pregnancy, including pre-eclampsia, HELLP syndrome or eclampsia
  • A fall or another type of shot in the abdomen
  • Smoking
  • The use of cocaine during pregnancy
  • Early rupture of membranes, causing leakage of amniotic fluid before the end of the pregnancy
  • Infection in the uterus during pregnancy (chorioamnionitis).
  • To be greater, especially in people over 40

Complications

Placental abruption can cause life-threatening problems for the mother and the baby.

For the mother, placental abruption can lead to:

  • Shock due to blood loss
  • Blood clotting problems.
  • The need for a blood transfusion
  • The failure of the kidneys or other organs resulting from the loss of blood
  • Rarely, the need for hysterectomy, if the uterine bleeding can't be controlled

For the baby, abruption of the placenta can lead to:

  • Growth-restricted for not receiving a sufficient amount of nutrients
  • Not receiving enough oxygen
  • Premature birth
  • Fetal death

Prevention

You can't prevent the detachment of the placenta, but you can reduce certain risk factors. For example, not smoking, not using illegal drugs, such as cocaine. If you have high blood pressure, work with your health care provider to control the condition.

Always use the seat belt when in a motor vehicle. If you have had abdominal trauma from a car accident, fall or another type of injury — seek medical help immediately.

If you have had a placental abruption, and you are planning another pregnancy, talk with your health care provider before you conceive to see if there are ways to reduce the risk that another detachment of the placenta.

Abruption of the placenta

Diagnosis

If your doctor suspects detachment of the placenta, he or she will do a physical exam to check the uterine tenderness or rigidity. To help identify possible sources of vaginal bleeding, your doctor will likely recommend blood and urine tests and an ultrasound.

During an ultrasound, high-frequency sound waves to create an image of your uterus on a monitor. Not always it is possible to see a detachment of the placenta on ultrasound, however.

Treatment

It is not possible to attach a placenta separates from the wall of the uterus. Treatment options for the detachment of the placenta depends on the circumstances:

  • The baby is not close to full term.If the detachment of the placenta seems mild, the baby's heartbeat is normal, and it is too soon for the baby to be born, you could be in the hospital for close monitoring. If the bleeding stops and your baby's condition is stable, you might be able to rest at home. You may be given medications to help your baby's lungs mature, and to protect the baby's brain, in case of early delivery if necessary.
  • The baby is close to full term. Typically after 34 weeks of pregnancy, if the abruption of the placenta seems to be a minimum, a closely monitored the vaginal delivery may be possible. If the abruption is worse or that jeopardize your or your baby's health, you need an immediate delivery, usually by cesarean section.

The baby is not close to full term. If the detachment of the placenta seems mild, the baby's heartbeat is normal, and it is too soon for the baby to be born, you could be in the hospital for close monitoring. If the bleeding stops and your baby's condition is stable, you might be able to rest at home.

You may be given medications to help your baby's lungs mature, and to protect the baby's brain, in case of early delivery if necessary.

For severe bleeding, you may need a blood transfusion.

Preparing for your appointment

Placental abruption is often a medical emergency, leaving no time to prepare. However, it is possible that your health care provider may notice signs of detachment of the placenta.

Depending on the suspected severity of abruption of the placenta, may be admitted to the hospital and monitored. Or, you may be admitted for emergency surgery to deliver the baby.

If you and the baby are being monitored in the hospital, here's some information to help you prepare for what's to come.

What you can do

While you're in the hospital:

  • Pay attention to the changes. Report to your health care team immediately if there is a change in their symptoms or their frequency.
  • Tell your doctor about all the medicines you have been taking , including vitamins and supplements. If you have smoked during pregnancy, or use illegal drugs.
  • Ask a friend or loved one to be with you, if possible. Someone that can help you remember the information provided, especially in the case of an emergency.

Some questions that you can ask your doctor include:

  • What tests do I need?
  • Is the baby in danger? Am I?
  • What are the treatment options?
  • What are the possible complications?
  • What can I expect if the baby is born now?
  • I'm going to need a blood transfusion?
  • What are the chances of my need for a hysterectomy after delivery?

What to expect from your doctor

Your doctor may ask you questions, including:

  • When did your signs and symptoms begin?
  • Have you noticed changes in your signs and symptoms?
  • How much bleeding have you noticed?
  • Can you feel your baby move?
  • Have you ever noticed clear fluid leaking from the vagina?
  • You've had nausea, vomiting, or dizziness?
  • You are going to have contractions? If so, how together are they?
Symptoms and treatment of Placental abruption