Placental Abruption

Though you may not think much about it, your placenta is a very important part of your pregnancy. Your placenta is actually an organ, which helps to deliver nutrients, blood, and oxygen to your baby. Typically, the placenta functions normally until birth, helping your baby grow strong and healthy. Sometimes, however, the placenta can develop problems, causing risks for you and your baby. Placental abruption is one placental complication that can occur during your pregnancy.

What is Placental Abruption?
Like placenta previa, placental abruption is a pregnancy complication that affects your placenta. It causes your placenta to detach from your uterus before labor and delivery. Typically, the placenta detaches after your baby is delivered. Sometimes though, the placenta begins to peel away from the uterus early. This can threaten your baby�s oxygen and food supply as well as your own health.

What Causes Placental Abruption?
The cause of placental abruption is still unknown. However, it is thought that certain factors may contribute to placental abruption in some women. These include:

 

  • having gestational diabetes
  • having preeclampsia
  • smoking during pregnancy

 

Who�s At Risk?
Placental abruption is not that uncommon, occurring in about 1 of every 120 births. It typically affects women in their third trimesters, though it can occur anytime after the 20th week. While any woman can develop placental abruption, it appears that certain women are at increased risk. Risk factors include:

 

  • having had a previous abruption
  • chronic hypertension
  • carrying multiples
  • being over age 35
  • smoking
  • using cocaine
  • having uterine fibroids

 

Symptoms of Placental Abruption
The main sign of placental abruption is dark red vaginal bleeding. This bleeding may be slight or it may be quite profuse. However, some women with placental abruption do not have any visible bleeding. Instead, blood clots hide behind their placenta, making it difficult to see. Other symptoms include:

 

  • abdominal pain or tenderness
  • nausea
  • excessive thirst
  • fainting
  • decrease in baby�s movements
  • cramping
  • severe contractions that don�t go away
  • blood in amniotic fluid

 

Diagnosis
The diagnosis of placental abruption is usually based upon your symptoms. Typically, an ultrasound is performed in order to view the placenta and to determine if there is any blood in the uterus. This ultrasound can also determine the health of your baby. Depending upon your symptoms and your ultrasound, you may be diagnosed with one of three grades of placental abruption:

 

  • Grade 1: little bleeding, no fetal distress
  • Grade 2: mild to moderate bleeding, contractions, and distressed fetal heart rate
  • Grade 3: moderate to severe bleeding or hidden bleeding, abdominal pain, and severe contractions

 

Complications Associated with Placental Abruption
Placental abruption can be quite serious, especially in cases where the placenta has detached completed or there is a large amount of bleeding. Complications include:

 

  • uncontrolled blood loss
  • formation of blood clots
  • premature birth
  • stillbirth
  • postpartum hemorrhaging

 

Treatment for Placental Abruption
Unfortunately, there is no cure for placental abruption. There is no way to reattach the placenta or to stop the placenta from continuing to detach. Treatment is focused on maintaining the health of mother and baby. Depending on how severe your abruption is, treatment procedures will vary.

If your abruption is mild and you have little bleeding, it is likely that you will be kept in hospital so that you can be monitored. As long as your baby does not appear to be stressed, you may be allowed to continue with the pregnancy. If you are close to term though, labor will probably be induced.

If you have a severe abruption or profuse bleeding, it is likely your baby will be delivered via cesarean section. If you are not yet 36 weeks pregnant, your baby may be given corticosteroids before delivery, in order to help develop her lungs and other organs. This will give her a much better chance at surviving early birth. Sometimes, if blood loss is severe, a transfusion is given.

 

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