Placent Abruptio

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Placental Abruption
(Premature Separation of Placenta, Ablatio Placentae, Abruptio Placentae)
Definition
Placental abruption is a condition that occurs during pregnancy when the placenta separates from the uterus before the fetus is delivered. The placenta is the organ that provides nourishment for the fetus while it is still in the uterus.
In a healthy pregnancy, the placenta remains attached to the uterine wall until after the fetus is delivered.
Placental abruption is not a particularly uncommon condition, with some form (ranging from very mild to the most severe) of the condition affecting approximately one in every 150 births. In very severe forms, placental abruption can cause death to the fetus. This occurs in approximately one in every 500-750 deliveries.
Death of the mother from placental abruption is extremely rare. Infants who survive delivery with placental abruption have a 40%-50% chance of experiencing complications.
Placental abruption can cause premature delivery, low birth weight, and significant blood loss for the mother.
Causes
The cause of placental abruption is often difficult to diagnose. Some common causes of the condition include:
• Injury to the abdomen from an accident or a fall
• Sudden decrease in the volume of the uterus, from significant loss of amniotic fluid or from the delivery of a first twin
• Abnormally short umbilical cord
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
The following factors increase your chance of developing placental abruption:
• Previous placental abruption in a prior pregnancy
• High blood pressure during pregnancy
• Pregnancy during older age
• Multiple previous deliveries (greater than average number)
• Excessively distended uterus
• Diabetes
• Drug use (cocaine)
• Cigarette smoking during pregnancy
• Alcohol abuse during pregnancy (more than 14 drinks per week during the pregnancy)
Symptoms
Symptoms include:
(In early stages, no symptoms may be present)
• Vaginal bleeding
• Abdominal pain
• Back pain
• Rapid contractions
• Soreness in the uterus
Diagnosis
Your doctor will ask about your symptoms and medical history, and perform a physical exam.
Tests may include the following:
• Pelvic examination
• Ultrasound—a test that uses sound waves to examine the abdomen
• Blood tests
o Prothrombin Time Test—tests time it takes for the plasma in the blood to clot
o Partial Thromboplastin Time Test—tests time it takes for the blood to clot
o Fibrinogen Test—tests blood levels of a protein that helps blood to clot
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include:
Intravenous Treatments
Fluids may be administered intravenously to replace lost fluids. Blood transfusions may also be given to replace lost blood supply.
The mother and fetus will be carefully monitored for signs of distress or shock, including abnormal heart rates.
Emergency Cesarean Delivery
If danger exists for mother or fetus, an emergency Cesarean delivery may be performed. If both the mother and fetus are at low risk of complications and the fetus is full-term, the mother may deliver vaginally.
Prevention
To help reduce your chance of getting placental abruption, take the following steps:
• Avoid drugs (especially cocaine), alcohol, and smoking during pregnancy.
• Receive proper and regular prenatal care throughout the pregnancy.
• Promptly treat conditions in the mother, including diabetes and high blood pressure.