Placental Abruption-Causes, Symptoms and Treatment

Pregnancy and delivery are unpredictable events. A well-progressing pregnancy can encounter a complication any time. Even if the pregnancy is completed successfully, expecting mothers may face unforeseen issues during labor and delivery. It is true; we should always think and hope for better things to happen. However, when it comes to pregnancy, it is always better to know the possible complications and its basic symptoms as many of the issues that pose danger for pregnancy, and health of the mother and the child can be rectified if found out earlier.

Here is everything you need to know about placental abruption, a  rare,  serious, yet a treatable pregnancy complication if caught earlier.

What is placental abruption?

Placental abruption is the untimely separation of the placenta from the uterine wall during pregnancy.  This happens when the baby is still inside the mother’s womb. The separation can be partial or complete. The separation can happen in any spot where the placenta attached to the uterine wall.

                                                                  

The placenta connects the growing baby to the mother’s uterus. Its typical location is in the upper part of the uterus. It acts as a “lifeline” that provides nutrients and oxygen to the baby through the umbilical cord. It remains there until the baby is born. Once the mother enters the last stage of the labor, the placenta separates from the uterus, and the uterine contractions help to push it into the birth canal and expel from the body. As it comes after the birth, it is called after birth.

However, once the Placental abruption happens, it can take away the oxygen and nutrients from the baby, and can end up with heavy bleeding in the mother as well.

What are the consequences of placental abruption?

A partial, mild abruption will not cause serious consequences. However, severe abruption or complete placental abruption can bring about:

  • Premature birth
  • Stillbirth
  • Severe and long-lasting health issues for the baby as a result of deprivation of oxygen and nutrition.
  • Severe blood loss leading to shock of the mother
  • Kidney failure

 How common is placental abruption?

Placental abruption is not a frequently occurring condition. It appears only one percent of the pregnancies.

When does placental abruption happen?

This condition most frequently appears in the second half of the third trimester. However, it can happen any time after the 20th week of pregnancy.

What causes placental abruption?

What causes placenta all of a sudden detaches from the uterine wall is still to be discovered. However, there are some factors that increase the risk of placental abruption. The risk factors include:

Age of the mother: Women getting pregnant after 35 years have a greater chance of undergoing placental abruption. The odds increase with the age.

Uncontrolled high blood pressure:  Pregnant women who have high blood pressure or conditions that trigger high blood pressure, like preeclampsia increase the risk of developing placental abruption.

History:  If the expecting mother has a previous history of placental abruption, repeating it in successive pregnancy increases. If there is a repeated previous history of placental abruption, there will be much more chances of placental abruption in the present pregnancy.

Amniotic fluid: Having too much amniotic fluid or the breaking of water prematurely increases the risk of placental abruption. 

Unhealthy lifestyle: If the mother has unhealthy lifestyles like smoking, using narcotic drugs like cocaine, excessive drinking of alcohol, etc, it will increase the chances of placental abruption.

Multiple pregnancies: Multiple pregnancies increases the risk of placenta detaching from the uterine wall, especially, after delivering the first baby vaginally. Similarly, multiple deliveries also increase the risk. More delivery more chances to have placental abruption.

Trauma: If the expecting mother is  involved in an accident, especially in an automobile accident, that causes trauma to the abdomen increases the chances of placental abruption.

Medical conditions: If the mother experiances medical issues like, blood clotting disorder, uterine abnormalities, uterine fibroids, etc., the chances of placental abruption increases. A short umbilical cord is another factor that increases the chances of placental abruption. Intrauterine growth restriction (IUGR) is another condition that could pave the way for placental abruption.

What are the symptoms of placental abruption?

Symptoms that point toward placental abruption depends on the severity and the spot where the detachment happened. Most commonly found warning signs of placental abruption are:

  • Vaginal bleeding. However, in around 20% of cases, placental abruption will not bring about any bleeding. This is because the placenta gets detached to a point where the blood is trapped behind the placenta instead of flowing towards the vagina.
  • Most women reported having some uterine tenderness or back pain during placental abruption.
  • Placental abruption can bring about rapid uterine contractions.
  • Abdominal pain. This again depends on the severity of the abruption. The pain It is directly proportional to the severity of the abruption.
  • Issues with Fetal heart rate or fetal movements.

When to seek medical attention?

Seek immediate medical attention if there is:

  • Vaginal bleeding, either spotting or profuse during the third trimester.
  • The water breaks and the fluid appear bloody
  • Cramping, uterine tenderness, abdominal pain, or back pain
  • Rapid uterine contractions or a contraction that doesn’t end
  • The baby isn’t moving as much as before

Any of these signs, irrespective of the cause, need to be brought to the attention of your doctor immediately. When it comes to pregnancy, prompt treatment counts  a lot for its safety progression and fair outcome 

How is placental abruption diagnosed?

Placental abruption usually is diagnosed based on the symptoms, the amount of bleeding, and pain and the fetal response.  Even though the specialist suspects placental abruption, it can only truly diagnose it after delivery. However, the doctors will collect as much information they could and will try to take the best decision for mother and child.

Tests for placental abruption include:

  • Careful evaluation of the symptoms
  • Ultrasound, either vaginal or abdominal
  • Fetal monitoring
  • Pelvic exam
  • Complete blood count
  • Platelet count

How to treat placental abruption?

Reattachment of the placenta is not possible and practical. Therefore, the treatment for placental abruption will depend upon the severity and how far the pregnancy is progressed.

  • If the mother experiences a mild placental abruption during 24 to 34 weeks with nominal bleeding and if the vital signs stay off the baby is regular, the doctors instruct for strict bed rest and discharge the woman.
  • If there is continuous bleeding, intravenous fluid is administered and starts medications to make the lung development of the fetus faster. This is as a precautionary measure to prepare for the possible preterm birth.
  • If the mother has a mild abruption and when the pregnancy near the full term, the doctor most probably recommend inducing labor or C section.
  • If the mother experiences severe abruption or if the abruption continues to progress, the only way to treat it is to deliver the baby mostly through C section as the blood loss will be a significant issue and mother or child have increased the risk of serious consequences

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