Placental abruption is an uncommon but severe pregnancy complication involving the placenta.  It is one of the causes of bleeding during the second half of pregnancy. (1)
This article will explore placental abruption symptoms, risk factors, causes, complications, and treatment options.

What does the placenta do?

The placenta is an organ that develops during pregnancy. The purpose of the placenta is to support the healthy growth of the baby by :

  • providing nutrients and oxygen to the baby;
  • disposing of the fetus waste products and dioxide carbon;
  • removing any substances that can be harmful to the baby;
  • producing hormones such as estrogen, progesterone, and lactogen. These hormones are indispensable for maintaining a healthy pregnancy, delivery, and breastfeeding;
  • providing temporary immune protection to the fetus and newborn with the transfer of antibodies from the mother.

What is placental abruption?

Placental abruption, also known as abruptio placentae, is the premature separation of the placenta from the inner wall of the uterus before delivery. Placental abruption can be partial or complete. In a normal pregnancy, the placenta grows onto the uterus and stays there until the delivery. Once the baby is born, it starts the third stage of labor, allowing the placenta to be expelled naturally from the uterus. In Placental abruption, the separation of the placenta usually occurs in the third trimester but can also happen any time after the 20th week of pregnancy.

What causes placental abruption?

In placental abruption, the maternal vessels tear away from the placenta and lead to bleeding between the uterine lining and the maternal side of the placenta. As the blood accumulates, it pushes the placenta away from the uterine wall.  The reason why the maternal vessels tear away remains unknown. However, some cases of placental abruption have been linked to abdominal trauma. It can happen in a car crash, an assault, or a fall. These events may cause the placenta to separate from the uterus.

What are the risk factors of placental abruption?

About 1 percent of pregnancies have placental abruption. While the exact cause in most cases is unknown, many factors can make someone more susceptible to placental abruption. (2)

Risk factors may include:

  • Hypertensive disorders, such as high blood pressure or preeclampsia.
  • Preterm premature rupture of membranes (water breaks before 37 weeks)
  • Previous placenta abruption
  • Smoking during pregnancy
  • Drug use, especially cocaïne
  • Infection inside the uterus
  • Advanced maternal age (being older than 35)
  • Being pregnant with multiple babies

Related: 20 Tips For A Healthy Pregnancy

What are the symptoms of placental abruption?

The main sign of placental abruption is dark, heavy vaginal bleeding. Some women might not experience any bleeding. The other symptoms of placental abruption may include :

  • Abdominal pain
  • Back pain
  • Tenderness or rigidity around the uterus
  • Frequent uterine contractions
  • Not feeling the baby move as much as before due to the decrease of baby’s supply of oxygen and nutrients.

The symptoms of placental abruption may look like other pregnancy complications such as placenta previa. Only your healthcare provider can make an accurate diagnosis by performing an ultrasound and blood tests.

What are the complications of placental abruption?

Placental abruption is a leading cause of maternal morbidity and perinatal mortality. The complications of placental abruption include :

  • Severe hemorrhage
  • Shock of the mother due to blood loss
  • Kidney failure or failure of other organs due to the blood loss
  • Premature birth (3)
  • Low birth weight (3)
  • Premature babies, especially those born very early, often suffer long-lasting medical issues.
  • According to the American Pregnancy Association (APA), if severe abruption occurs, 15% ends in fetal death. Infants who survive have a 40-50% chance of developing long-term health complications. (4)

What is the treatment for placental abruption?

The onset of placental abruption is often sudden and intense and requires immediate treatment.
There is no way to stop placental abruption or reattach the placenta. The treatment depends on the severity of the abruption, the bleeding, and the age of the pregnancy.

Mild cases

In mild cases, the only treatment needed is bed rest and close monitoring. When there is no bleeding or the bleeding has stopped, the mother may be allowed to go home and rest with regular check-ups at the hospital.
When there is bleeding but it does not threaten the mother and the baby’s life; the mother may be admitted into the hospital to monitor until your baby is old enough for the doctor to induce labor safely. Doctors might also recommend medicines to help the baby’s lungs mature faster in case of early labor.

Moderate to severe cases

Immediate delivery is the safest course of action. Vaginal delivery is possible if the baby is stable. If the fetus is in distress or the mother has heavy bleeding, then a cesarean delivery would be necessary. The mother might also need a blood transfusion. In rare instances, if the doctors cannot control the bleeding, they may need to perform a hysterectomy, i.e., surgical removal of the uterus.

Can you prevent placental abruption?

In most cases, placental abruption is not preventable. However, there are steps you can take to reduce your risk.

  • Get treatment if you have high blood pressure.
  • Avoid smoking and drugs like cocaine.
  • If you have had a placental abruption, you should tell your doctor. They will monitor you closely. Placental abruption in a previous pregnancy can significantly increase the risk of placental abruption in a subsequent pregnancy.
  • Always wear a seat belt when every time you are in a car or a truck. Learn how to wear a seat belt properly, according to the U.S. Department Of Transportation.

 Seek immediate medical help if you have abdominal trauma from a car accident, a fall, or other injuries.

References

  1. https://www.statpearls.com/articlelibrary/viewarticle/17041/
  2. https://pubmed.ncbi.nlm.nih.gov/24965988/
  3. https://pubmed.ncbi.nlm.nih.gov/28595292/
  4. https://americanpregnancy.org/pregnancy-complications/placental-abruption-925

 

Click to access pregnant-seat-belt-use.pdf

 

 

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About the Author

Hermione M.

My name is Hermione. I am the founder of WomenH and I write about women's health, wellness, mental health, and personal growth. I created this platform to inspire women to take care of themselves mentally, physically, and emotionally to become their best selves. Thank you for stopping by.

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