Placental abruption
Placental abruption
is the separation of the placenta from the lining of the uterus. This condition
usually occurs during the third trimester but can occur any time after the 20th
week of pregnancy. Only about 1% of all pregnant women experience placental abruption,
and most can be successfully treated depending on the type of abruption.
What are the signs and symptoms of placental abruption?
Signs and symptoms of
placental abruption include one or more of the following:
- Vaginal bleeding (although about 20% of cases will have no bleeding)
- Uterine tenderness
- Rapid contractions
- Abdominal pain
- Fetal heart rate abnormalities
Any vaginal bleeding
in the third trimester should be reported to the doctor immediately. Another
cause of vaginal bleeding may be placenta previa. Your doctor will know the
correct diagnosis.
What actually happens in placental abruption?
The placenta is part
of your baby's life support system. It transfers oxygen and nutrients to your
baby. When the placenta separates from the uterine lining before delivery, it
can interrupt the transport of oxygen and nutrients to the baby. Placental
abruption cannot be accurately diagnosed until a placental examination is
performed after birth. There are several methods that are used to make this diagnosis
during pregnancy so that proper treatment can be applied.
This includes:
- Ultrasound
- Evaluation of patient’s symptoms (bleeding, pain)
- Blood tests
- Fetal monitoring
How to treat placental abruption?
Treatment depends on
the severity of the discharge, the location of the separation, and the age of
pregnancy. There may be a partial split or a complete split (also called a full
split). There may also be varying degrees of each, which will affect the type
of treatment recommended. In case of partial separation, bed rest and close
observation may be prescribed if the pregnancy has not reached maturity. In
some cases, blood transfusions and other emergency treatments may also be
needed.
In the event of
complete or complete separation, childbirth is often the safest course of
action. If the fetus is stable, vaginal delivery is possible. If the fetus is
in distress or the mother is bleeding heavily, a caesarean section is
necessary. Unfortunately, no treatment can prevent placental abruption and
there is no way to reattach it.
Any type of placental
abruption can lead to preterm labor and low birth weight. In cases where severe
placental abruption occurs, approximately 15% end in fetal death.
What causes placental abruption?
The causes of
placental abruption are not fully known.
However, women are at
higher risk for this condition if they:
- Smoke
- Use cocaine during pregnancy
- Are over the age of 35
- Have preeclampsia or hypertension
- Are pregnant with twins or triplets
- Have had a previous placental abruption
- Experience trauma to the abdomen
- Have abnormalities in the uterus
When should I call my doctor?
You should call your doctor immediately if you experience bleeding during your third trimester. Only your doctor can correctly diagnose the cause of late bleeding. The outcome of the diagnosis of placental abruption improves with timely and accurate treatment.