Placental abruption means the placenta has detached (come away) from the wall of the uterus, either partly or totally. This can cause bleeding in the mother. It may also interfere with the unborn baby’s supply of oxygen and nutrients, which the placenta provides from the mother’s bloodstream through the lining of the uterus. Doctors cannot reattach the placenta. Without prompt medical treatment, a severe case of placental abruption can have dire consequences for the mother and her unborn child, including death. Worldwide, placental abruption occurs in about one pregnancy in every 100. In about half of cases, placental abruption is mild and can be managed by ongoing close monitoring of the mother and baby. About 25 per cent of cases are moderate, while the remaining 25 per cent threaten the life of both baby and mother. SymptomsSome of the symptoms and signs of moderate to severe placental abruption include:
In some cases, bleeding may occur but the blood may clot between the placenta and the wall of the uterus, so vaginal bleeding may be scanty or even non-existent. This is known as a ‘retroplacental clot’. The cause is unknown in most casesIn most cases, doctors don’t know the exact cause or causes of placental abruption. It is thought that an abnormal blood supply in the uterus or placenta may play a role, but the cause of the suspected abnormality isn’t clear. Some of the known causes of placental abruption include:
Risk factorsWhile the exact cause in most cases is unknown, certain factors make a pregnancy more susceptible to placental abruption. Risk factors may include:
ComplicationsComplications in severe cases can include:
DiagnosisThe symptoms and signs of placental abruption can mimic those of other pregnancy conditions, such as placenta previa and pre-eclampsia. Information that may be used to diagnose placental abruption includes:
Sometimes, the diagnosis of placental abruption can’t be confirmed until childbirth, when the placenta is delivered with an attached blood clot that appears old rather than fresh. The placenta is usually sent to a laboratory for further diagnostic testing. TreatmentAll cases of suspected placental abruption, regardless of severity, should be closely monitored to protect the health and safety of the mother and child. This monitoring is usually done in hospital and should include regular checks of the vital signs of both mother and baby. Treatment depends on the severity of the condition but may include:
PreventionWhile it is impossible to prevent placental abruption, the risk can be reduced. Suggestions include:
Where to get help
Things to remember
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