Your pregnancy: Placental abruption

Wednesday, June 18, 2014

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Placental abruption (abruptio placentae) is an uncommon yet serious complication of pregnancy.

The placenta is a structure that develops in the uterus during pregnancy to nourish the growing baby. If the placenta peels away from the inner wall of the uterus before delivery — either partially or completely — it's known as placental abruption. Placental abruption can deprive the baby of oxygen and nutrients and cause heavy bleeding in the mother.

Placental abruption often happens suddenly. Left untreated, placental abruption puts both mother and baby in jeopardy.

Placental abruption is most likely in the last 12 weeks before birth. Classic signs and symptoms of placental abruption include:

* Vaginal bleeding

* Abdominal pain

* Back pain

* Uterine tenderness

* Rapid uterine contractions, often coming one right after another

In some cases, placental abruption develops slowly. If this happens, you might notice light, intermittent vaginal bleeding. Your baby might not grow as quickly as expected, and you might have low amniotic fluid (oligohydramnios) or other complications.

The specific cause of placental abruption is often unknown. Possible causes include trauma or injury to the abdomen — from an auto accident or fall, for example — or rapid loss of the fluid that surrounds and cushions the baby in the uterus (amniotic fluid)

Various factors can increase the risk of placental abruption, including:

* Previous placental abruption.

* High blood pressure.

* Abdominal trauma.

* Substance abuse.

* Premature rupture of the membranes. During pregnancy, the baby is surrounded and cushioned by a fluid-filled membrane called the amniotic sac. The risk of placental abruption increases if the sac leaks or breaks before labour begins.

* Blood-clotting disorders.

* Multiple pregnancy.

* Maternal age. Placental abruption is more common in older women, especially after age 40.

Placental abruption can cause life-threatening problems for both mother and baby.

For the mother, placental abruption can lead to:

* Shock due to blood loss

* Blood clotting problems

* The need for a blood transfusion

* Failure of the kidneys or other organs

For the baby, placental abruption can lead to:

* Deprivation of oxygen and nutrients

* Premature birth

* Stillbirth

After the baby is born, bleeding from the site of the placental attachment is likely. If the bleeding can't be controlled, emergency removal of the uterus (hysterectomy) might be needed.

You can't directly prevent placental abruption, but you can decrease certain risk factors that make placental abruption more likely. For example, don't smoke or use illegal drugs, such as cocaine. If you have high blood pressure, work with your health care provider to control the condition.

If you've had a placental abruption and are planning another pregnancy, talk to your health care provider about ways to reduce the risk of another abruption before conceiving again. Expect your health care provider to carefully monitor your condition throughout the pregnancy.

—Mayo Clinic




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