Placental Abruption
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Placental Abruption

(Premature Separation of Placenta; Ablatio Placentae; Abruptio Placentae)

Pronounced: pluh-SEN-tul ab-RUP-shun

En Español (Spanish Version)

Definition

Placental abruption occurs 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.

Some form of the condition affects about 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 very rare. Infants who survive a birth with the condition have a 40%-50% chance of experiencing complications.

Placental abruption can cause:

  • Premature delivery
  • Low birth weight
  • Significant blood loss for the mother

Placental Abruption

Placental Abruption

© 2008 Nucleus Medical Art, Inc.

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
  • Acute development of high blood pressure (often associated with cocaine use)

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
    • Prothrombin time test—tests time it takes for the plasma in the blood to clot
    • Partial thromboplastin time test—tests time it takes for the blood to clot
    • 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.

RESOURCES:

The American College of Obstetricians and Gynecologists
http://www.acog.org

American Pregnancy Association
http://www.americanpregnancy.org

March of Dimes
http://www.marchofdimes.com

CANADIAN RESOURCES:

British Columbia Ministry of Health
http://bchealthguide.org

The Society of Obstetricians and Gynaecologists of Canada
http://sogc.medical.org/

References:

Bleeding in pregnancy, placenta previa, placental abruption. High-risk pregnancy. Lucile-Packard Children's Hospital website. Available at: http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/hrpregnant/bleed.html . Accessed July 2, 2007.

Placenta abruptio. Medline Plus Medical Encyclopedia. US National Library of Medicine website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000901.htm . Accessed July 2, 2007.

Pregnancy: placental abruption. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/placental-abruption/DS00623/DSECTION=1 . Accessed July 2, 2007.



Last reviewed April 2008 by Ganson Purcell Jr., MD, FACOG, FACPE

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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