Placental abruption is the premature separation of a placenta from its implantation in the uterus. Within the placenta are many blood vessels that allow the transfer of nutrients to the fetus from the mother. If the placenta begins to detach during pregnancy, there is bleeding from these vessels. The larger the area that detaches, the greater the amount of bleeding. Placental abruption occurs about once in every 120 births. It is also called abruptio placenta.
What causes Placenta Abruption?
Other than direct trauma to the uterus such as in a car accident, the cause of placental abruption is unknown. It is, however, associated with certain conditions, including the following:
Previous pregnancy with placental abruption
Hypertension (high blood pressure)
Cigarette smoking
Multiple pregnancy
Why is Placenta Abruption dangerous?
Placental abruption is dangerous because of the risk of uncontrolled bleeding (hemorrhage). Although severe placental abruption is rare, other complications may include the following:
Hemorrhage and shock
Disseminated vascular coagulation (DIC) - a serious blood clotting complication.
Poor blood flow and damage to kidneys or brain
Stillbirth
Postpartum (after delivery) hemorrhage
What are the symptoms of Placenta Abruption?
The most common symptom of placental abruption is dark red vaginal bleeding with pain during the third trimester of pregnancy. It also can occur during labor. However, each woman may experience symptoms differently. Symptoms may include:
Vaginal bleeding
Abdominal pain
Uterine contractions that do not relax
Blood in amniotic fluid
Nausea
Thirst
Faint feeling
Decreased fetal movements
The symptoms of placental abruption may resemble other medical conditions. Always consult your physician for a diagnosis.
How is Placenta Abruption diagnosed?
The diagnosis of placental abruption is usually made by the symptoms, and the amount of bleeding and pain. Ultrasound may also be used to show the location of the bleeding and to check the fetus. There are three grades of placental abruption, including the following:
Grade 1 - small amount of vaginal bleeding and some uterine contractions, no signs of fetal distress or low blood pressure in the mother.
Grade 2 - mild to moderate amount of bleeding, uterine contractions, the fetal heart rate may shows signs of distress.
Grade 3 - moderate to severe bleeding or concealed (hidden) bleeding, uterine contractions that do not relax (called tetany), abdominal pain, low blood pressure, fetal death.
Sometimes placental abruption is not diagnosed until after delivery, when an area of clotted blood is found behind the placenta.
How is Placenta Abruption treated?
Specific treatment for placental abruption will be determined by your physician based on:
Your pregnancy, overall health, and medical history
Extent of the disease
Tolerance for specific medications, procedures, or therapies
Expectations for the course of the disease
Your opinion or preference
There is no treatment to stop placental abruption or reattach the placenta. Once placental abruption is diagnosed, a woman's care depends on the amount of bleeding, the gestational age, and condition of the fetus. Cesarean delivery is performed for most cases of placental abruption and emergency delivery may be needed if hemorrhage occurs. Severe blood loss may require a blood transfusion.
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