Placental abruption is when the placenta, which provides food and oxygen to the baby in the belly, comes off the wall of the uterus too early. This is also called abruption placenta.
When this happens, the baby loses its lifeline, which can lead to problems like being born too early or not getting enough oxygen, and sometimes even death before birth. Researchers have seen that babies who survive placental abruption may still face a higher chance of dying, even after the first week of being born.
For the mom, placental abruption can cause heavy bleeding and is a very serious emergency.
Placental abruption usually happens in the last part of pregnancy, but it can also occur earlier. It affects about 1 in 100 pregnancies.
Signs / Symptoms of Placental Abruption
When the placenta comes off the uterine wall, the blood vessels that connect the placenta to the uterine lining start to bleed. How much bleeding and the symptoms depend on how much of the placenta has detached.
Placental abruption can be mild, moderate, or severe. In mild cases, only part of the placenta has come off, so there might not be many symptoms or they might be mild.
Moderate to severe cases involve a more significant separation or complete detachment of the placenta. In severe situations, it can lead to serious problems for the mom like shock, heavy bleeding, and even the death of the baby.
The main sign of placental abruption is bleeding from the vagina during the last part of pregnancy, and this bleeding is often accompanied by pain. Other signs include:
– Pain or tenderness in the belly
– Strong and painful contractions close together
– Back pain in pregnancy
– Blood in the amniotic fluid
– Feeling faint
– The baby not moving as much as before
If you see blood from your vagina or feel strange pain in your belly while you’re pregnant, call your doctor right away. It’s important to get help quickly to make sure you and your baby stay healthy. Don’t wait if you’re worried – just give your doctor a call.
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Causes and Risk Factors
In a regular pregnancy, the placenta comes off the uterus wall during the third stage of labor. But with placental abruption, it comes off too soon. This can happen during pregnancy or while giving birth in the first or second stage.
We’re not exactly sure why placental abruption occurs, but it happens when something messes up the blood vessels in the placenta.
Certain things can make someone more likely to have placental abruption. Some of these things can’t be avoided, but there are things you can do to lower your chances. These include:
– Had placental abruption in a previous pregnancy
– Long-term high blood pressure
– Sudden high blood pressure during pregnancy (called preeclampsia)
– Heart disease
– Getting hit in the belly
– Smoking
– Drinking alcohol
– Using cocaine
– Having growths in the uterus called fibroids
– Being over 40
– Having more than one baby at a time (like twins or triplets)
– The bag of waters breaking suddenly
Diagnosis
Doctors usually identify placental abruption based on symptoms, especially bleeding and belly pain. An ultrasound, which uses sound waves to show the baby and placenta, can help locate the placenta. However, it’s not always easy to spot placental abruption on ultrasound because bleeding around the placenta can look similar to the placenta itself.
The only way to confirm placental abruption is to check the placenta after the baby is born. If the placenta has detached early, there will likely be a clotted blood area.
Bleeding in the later part of pregnancy can happen for other reasons too, like something called placenta previa. Your doctor needs to figure out what’s causing the bleeding to give you the right treatment.
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Placenta Previa:
– The start might not be obvious
– You can see vaginal bleeding
– Anemia and shock match the amount of bleeding you can see
– No pain
– The uterus stays soft
Placental Abruption:
– Can start suddenly and be strong
– May or may not have vaginal bleeding
– Anemia and shock might be more than you expect from the visible bleeding
– Strong belly pain
– The uterus becomes very hard
Treatment
If the placenta has come off from the uterus, it can’t be reattached. Instead, your doctor will figure out how bad it is and decide the best way to take care of you and your baby.
For mild cases:
– If the symptoms are not too bad and you and your baby are okay, your doctor might keep a close eye on you. They may admit you to the hospital to be safe and monitor you until it’s time to have the baby.
For moderate or severe cases:
– If the symptoms are more serious, the safest thing is to deliver the baby. Depending on the situation, this could be through normal delivery or a C-section (a surgery to take the baby out).
– If your baby is not doing well, your doctor might do an emergency C-section.
– If you’re losing a lot of blood, you might need a blood transfusion to help you.
Complications
Placental abruption is linked to high rates of problems for the baby and mom. Premature birth and problems with getting enough oxygen during birth are the main reasons for these issues.
The chance of the baby not surviving because of placental abruption is around 10%. How things turn out depends on how serious the problem is.
Complications that can happen because of placental abruption include:
– Severe bleeding
– Baby not surviving
– Mom not surviving
– Baby being born too early
– Problems with blood clotting
– Issues from blood transfusions
– Having to remove the uterus (hysterectomy) through surgery
– Complications from having a C-section
– Higher chance of heart problems
Placental abruption is a pregnancy problem where the placenta comes off the uterus too early. This can cause bleeding and a shortage of oxygen for the baby, posing risks for both the parent and baby.
Doctors identify it through symptoms, like bleeding from the vagina. Treatment might involve keeping a close eye on things or delivering the baby right away through normal birth or C-section. The choice depends on the severity of the situation.
FAQ
Q: What is placental abruption?
– That is a pregnancy complication where the placenta separates from the uterus before the baby is born, leading to potential risks for both the parent and the baby.
Q: What are the symptoms of placental abruption?
– Common symptoms include vaginal bleeding, abdominal pain, intense contractions, back pain, and changes in the baby’s movement. However, it’s essential to consult with a healthcare provider for an accurate diagnosis.
Q: How is placental abruption diagnosed?
– This is primarily diagnosed based on symptoms, such as bleeding and pain. Imaging techniques like ultrasound may be used, although it may not always provide a definitive diagnosis.
Q: What are the risk factors for placental abruption?
– Risk factors include a history of placental abruption in a previous pregnancy, high blood pressure, preeclampsia, trauma to the abdomen, smoking, alcohol or cocaine use, uterine fibroids, advanced maternal age, and carrying multiples (twins, triplets, etc.).
Q: Can placental abruption be prevented?
– While some risk factors are beyond control, maintaining a healthy lifestyle, attending regular prenatal check-ups, and following medical advice can contribute to a healthier pregnancy, potentially reducing the risk of complications.
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