Placental abruption (prenatal period)

Placental abruption occurs when the placenta peels away from the inner wall of the uterus before delivery, either partially or completely. Placental abruption can deprive the baby of oxygen and nutrients and cause heavy bleeding in the mother.

What are the Signs and Symptoms of Placental Abruption?

Placental abruption will usually occur in the last 12 weeks of pregnancy. The most noticeable sign of placental abruption is visible vaginal bleeding. Although, there are many cases in which the placental abruption is concealed as a result of the blood being retained between the uterus and the detached placenta. Additional symptoms include abdominal and/or back pain, uterine tenderness, and rapid uterine contractions.

What are the Risk Factors of Placental Abruption?

Past pregnancies resulting in placental abruption increase the risk of this condition. Increased maternal age and diabetes mellitus are also associated with this condition. Hypertension is linked to approximately 50% of placental abruptions resulting in fetal death. Any condition that weakens the blood’s ability to clot increases the risk of placental abruption. Substance abuse including cigarette smoking, excessive drinking, and cocaine use, increase the risk of placental abruption. If these risk factors exist, your health care professional should be watchful because of the possibility of placental abruption.

What are the Complications of Placental Abruption?

Placental abruption can be life threatening to both the baby and mother. Proper nutrients may be prevented from reaching the baby through the umbilical cord. The baby could also be at risk of suffering hypoxia, or oxygen loss, leading to brain injury. Excessive loss of blood can result from a placental abruption, and may result in shock to the fetus. The mother is also at risk of shock due to blood loss. In some cases there is a need for a blood transfusion for the mother.

How is Placental Abruption Diagnosed?

Your health care professional will perform a physical examination checking for uterine tenderness if signs or symptoms of placental abruption appear. Blood tests will also be administered, such as a CBC, which may point to decreased hematocrit or hemoglobin and platelets. Other tests such as partial thromboplastin time test or fibrinogen level test could be performed.

How is Placental Abruption Treated?

Depending upon the progression of your pregnancy, there are measures that can be taken to decrease the level of complication and risk to you and your baby. An abruption may be mild, requiring hospitalization for only a short time, once the baby’s condition is stable and the bleeding stops. You may be able to rest at home, while taking medicines that help your baby’s lungs mature. If the abruption is discovered after 34 weeks, and the abruption is mild, a vaginal delivery still may be possible. In more serious cases of placental abruption, treatment may include intravenous fluid replacement, blood transfusion, and monitoring of the mother and baby for shock.

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