Placental Abruption

Placental Abruption: Causes, Picture, Symptoms, Risk And Treatment

Placental abruption is an uncommon yet a dangerous condition during pregnancy. Your pregnancy seems to progress smoothen when all of a sudden you experience bleeding and pain. The condition also referred to as abruptio placentae can make you scared and fear for the safety of your baby. The condition requires immediate medical attention as, without treatment, it can harm both the expectant mother and baby. Pregnant women develop placenta in the uterus after conception. The placenta is responsible for sending oxygen and nutrient from the mother to the unborn baby. It is attached to the uterus wall and remains there till the baby is born. Your baby is attached to the placenta through the umbilical cord. The abruption of the placenta results in the separation from the uterus. It is harmful to the child as it cannot survive on its own.

What Do You Mean By Placental Abruption?

Before going into detail about the condition, you need to know the importance of the placenta. It is a large organ that develops after conception. The placenta gets itself attached to the top or side of the uterus. Your baby is connected to the placenta through the umbilical cord. In normal cases, the blood from the mother passes through the placenta to the baby. The placenta filters the oxygen, glucose, and other nutrients in the mother’s blood to the baby via the umbilical cord. Your placenta also produces several important hormones like oestrogen, lactogen, and progesterone needed to sustain the pregnancy. The placenta also separates the mother’s blood from the baby’s blood. This action keeps the baby protected against infections. At the end stages of pregnancy, it passes antibodies for protecting the baby after delivery.

Placental Abruption

Placental abruption is the condition occurring when the placenta separated from the inner wall of the uterus partially or completely before delivery. It can result in restriction or complete blocking of oxygen and nutrients supply to the baby. So, the expectant mother can experience heavy bleeding due to the separation of the placenta from the uterus wall. The condition happens suddenly without any prior symptoms. When you see the signs, it is important to seek medical assistance as early as possible. Without treatment, the condition endangers both mother and baby.

Symptoms Of Placental Abruption

Symptoms Of Placental Abruption

The separation of the placenta from the uterus wall is not a common condition. It affects only 1% of the total population of pregnant women. It is a condition that you can experience any time after your 20th week of pregnancy. But, women in their third trimester suffer from it the most. It is a sudden problem, leading to vaginal bleeding. You can see vaginal bleeding varying with the severity. So, mild bleeding indicates not so severe abruption of the placenta while severe bleeding indicates a serious issue. In some cases, you may not see bleeding as the blood gets trapped inside your uterus. Maintain caution when you see the following signs and symptoms:

  • Vaginal bleeding
  • Back Pain
  • Abdominal pain
  • Uterine contraction (you can experience it coming one after another)
  • Uterine tenderness
  • Firmness in the uterus
  • Tightness feeling in your abdomen

You can experience the back and abdominal pain suddenly. It can accompany with vaginal bleeding. You can suspect it as pregnancy-related complications like miscarriage or ectopic pregnancy. Every woman is different. So, the amount of bleeding may vary for the condition. Some women may not see visible bleeding even when they suffer from other signs. It is because the blood gets trapped in the uterus. So, even with the placenta separating from the uterus wall, no vaginal bleeding occurs. The fetus may not grow quickly as expected in normal cases. The condition can also result in oligohydramnios (low level of amniotic fluid) and other complications. You must seek immediate medical attention when you observe one or more symptoms associated with the condition. With prompt medical care, you can avoid complications to your baby or your health.

Causes Of Placental Abruption

Doctors cannot pinpoint an exact cause triggering the separation of the placenta from the uterus wall. So, the exact reason, which causes the problem remains unclear. It is not a common problem. So, it does not affect every woman who is pregnant. But, certain risk factors can result in the condition. It is a dangerous condition for both the expectant mother and the child in the womb. You need to understand the issues increase the risk of placental abruption. It will help you take ample precautions to safeguard your and the baby’s health.

Risk Factors Leading To Placental Abruption

Placental AbruptionSome factors influence the high risk associated with abruption of the placenta. So, women who experience one or more of the following factors can face the risk of dislodging of the placenta from the uterus wall.

Prior Abruption

Mothers who have suffered placental abruption in their previous pregnancy need to maintain caution in their next pregnancy. You have a high chance of experiencing the problem. It is true unless the abruption occurs due to external trauma and you do not suffer trauma during the current pregnancy.

High Blood Pressure

Women suffering from chronic hypertension face the risk of abruption of the placenta. High blood pressure causes abnormal bleeding between the uterus wall and the placenta. So, it increases the risk of preeclampsia or eclampsia.

Smoking

Women who smoke before and during pregnancy have a high risk of abruption of the placenta. Smoking exposes you to tobacco, which can affect placental development. It also restricts the blood flow to the placenta, leading to its separation from the uterus wall.

Issues With Amniotic Sac

The amniotic sac is filled with fluid. It offers protection to your baby inside the uterus as it acts as a cushion. Some women experience breaking or leaking of fluid before birth. The condition occurs due to the early rupture of membranes. So, it increases the chances of abruption of the placenta.

Use Of Cocaine

Pregnant women who use cocaine during their pregnancy. The drug crosses the placenta. It makes the placenta weak, leading to the separation from the uterus wall.

Chorioamnionitis

Chorioamnionitis

It is the infection triggering the inflammation of fetal membranes. Also known as intra-amniotic infection, it affects amnion and chorion. Prolonged labor can cause bacteria to ascend from the vagina into your uterus. So, the bacteria cause infection, which can result in the separation of the placenta.

Pregnancy In Later Stages

Getting pregnant in the later stages of your life can increase the chances of complications. It also increases the risk of separation of the placenta from the uterus. It is common among mothers above forty years of age.

Multiple Pregnancy

Multiple Pregnancy

Women carrying more than one baby can suffer from high blood pressure. It increases the risk of early detachment of the placenta from the uterus. The detachment can also occur after delivering the first baby and before the next one is born.

Abdominal Trauma

Trauma to your abdomen can occur when you fall and hit the stomach. The trauma can cause your placenta to extricate from the uterus wall. Abdominal trauma can also occur in a traffic accident and you suffer injuries to the abdomen. So, when you travel in a car, always wear your seatbelt.

Complications Due To Placental Abruption

Placental abruption is a serious problem that can cause life-threatening consequences for the expectant mother and the baby inside the womb. It is important to see a doctor as soon as you observe the symptoms associated with the condition. Ignoring the problem can only trigger complications like:

Complications To The Mother

Abruption of the placenta can lead to the following issues in the expectant mother:

  • Shocked caused due to sudden blood loss
  • An issue with blood clotting (problems like disseminated intravascular coagulation)
  • Significant blood loss causing organ damage (including kidney failure)
  • The need for blood transfusion

In rare cases, when the condition becomes severe and the doctor cannot stop the bleeding, you need to undergo a hysterectomy. It is the surgical procedure to remove the reproductive organs. So, you become permanently infertile.

Complications To Unborn Baby

Abruption of the placenta can harm the unborn baby. The issues affecting the baby in the uterus due to the dislodging of the placenta from the uterus wall are:

Constrained Growth

The baby suffers from restricted growth in the uterus due to not getting proper nutrients. Babies experiencing such problem may not grow like normal babies. They can suffer from breathing problems, infection or other issues. The child also faces the risk of death. After birth, the child faces a high risk of the blood vessel and heart problems.

Restricted Oxygen Supply

The condition can restrict the oxygen supply to the unborn baby. It results in the condition known as uterine hypoxia. The oxygen deprivation can cause breathing problems. Infants experiencing the condition can also have too much acid present in their bodily fluids. Some children experience brain damage, other brain disorders or damaged organs.

Premature Birth

Premature birth refers to early birth that takes place before three weeks of the actual delivery date. The babies born before their due date have low birth weight. The condition results in short-term and long-term medical complications.

Stillbirth

Stillbirth refers to the death or loss of the baby occurring after the twentieth week of pregnancy. The child dies before or during the delivery. It is a devastating experience for expectant parents.

Diagnosing Placental Abruption

If you are pregnant and notice signs of bleeding from the vagina, then you need to see a doctor as early as possible. Your doctor diagnoses the problem based on the symptoms like the severity of the bleeding and pain. The condition, mostly mimics other pregnancy complications like pre-eclampsia or placenta previa.

Medical History

The first step is to understand the medical history of the omen. Certain health conditions like high blood pressure or the use of recreational drugs can experience abruption of the placenta. It is essential to detect the exact cause of the problem to provide a suitable solution.

Physical Examination

Physical examination includes checking the uterus for tenderness as well as rigidity. The physical examination checks the tenderness and rigidity of the uterus. The tone of the uterus is checked to determine the exact cause of vaginal bleeding.

Internal Examination

The gynecologist uses a speculum, the special instrument to examine the internal region of the vagina and cervix.

Blood Tests

To understand the exact source of the problem, your doctor suggests a blood test. The most common one is the KB (Kleihauer-Betke) test. A sample of maternal blood is sent to the lab for testing. It measures the amount of fetal hemoglobin transferred from the fetus to the mother’s blood.

Ultrasound

High-frequency sound waves can create clear images of the uterus and placenta. Your doctor can see the uterus on a monitor and detect possible abruption of the placenta. But, in some cases, the placenta may not appear on ultrasound.

Fetal Heartbeat Monitoring

Fetal Heartbeat Monitoring

Moderate cases of abruption of the placenta can affect the child. So, your doctor can use the fetal heart rate monitoring to measure the heart rate of the fetus. The rhythm will offer an idea about how the baby is doing.

In some cases, the condition remains undiagnosed until childbirth. The doctor can confirm the problem only after delivery. It is detected while examining the placenta. The presence of old blood clot attached to the placenta can point towards mild abruption. Your doctor sends it to the lab for further diagnostic testing.

Treatment For Placental Abruption

Remember, it is impossible to reattach the separated placenta back to the wall of the uterus. So, regardless of the severity, the suspected abruption requires medical attention. You need to seek treatment in the hospital. The doctor closely monitors the condition to safeguard the life of mother and child. It is important to regularly check the vital signs of the mother and baby to detect any problem. The treatment options for the condition depends on the circumstances and severity. Therefore, the different options include

Mild Cases In Early Pregnancy

The early pregnancy (any time before 34 weeks gestation) means the baby is not fully developed. The mild abruption may not distress the baby. If the heart rate is normal and the vaginal bleeding stops, then you need to take complete rest. Since it is too soon for the delivery of the baby, your doctor arranges for regular check-ups till the due date. It is to monitor if the condition changes or causes any harm to the baby’s health. At first, you need hospitalization for close monitoring. Once the bleeding stops and the baby’s condition is stable, you can go back home to rest.

Moderate Cases In Early Pregnancy

If you suffer from moderate cases of separation of the placenta from the uterus before 34 weeks of gestation, then you need to stay in the hospital until your doctor can safely deliver the baby. So, you have to remain in bed rest at the hospital until 36 weeks of pregnancy. During your stay in the hospital, the doctor prescribes medication like corticosteroids for the baby’s lungs to mature quickly. It is a precautionary measure to help the baby have mature lungs in case of early delivery.

Mild To Moderate Cases In Late Pregnancy

If you experience the mild separation of the placenta from the uterus wall after 34 weeks of gestation, your doctor monitors the condition closely until 36 weeks of gestation. After 36 weeks, the doctor recommends vaginal delivery. In some cases, during the delivery, the placenta separates further from the uterus wall. So, to protect the baby and mother, the doctor switches to delivery via C-section. Cesarean section is preferred when something jeopardizes the baby’s or mother’s health.

Severe Cases

In severe cases of the condition, your doctor opts for immediate delivery. It is the safest treatment option to save the baby and mother. If you suffer heavy bleeding, then blood transfusion is recommended to compensate for the lost blood. Emergency hysterectomy is performed when the bleeding is profuse with no signs of stopping. In some cases, the doctor can opt for blood transfusion as well as emergency hysterectomy.

Preventing Placental Abruption

Babies born to mothers who experience placental abruption can suffer from pregnancy-related complications. If you suffer from the problem, then your babies face a high risk of the following problems:

  • Problems to grow at a normal rate
  • Premature birth (babies birth occurring before 37 weeks of pregnancy)
  • Stillborn babies

You have no sure shot method to prevent the placenta from separating the uterus. But, you can take some steps during pregnancy to reduce the risk. So, you need to follow the guidelines suggested below:

Avoid Using Drugs

Using recreational drugs can harm both the baby and the mother. Illegal drugs like cocaine increase your risk of pregnancy complications like separation of the placenta from the uterus. So, stay from the drugs and remain clean throughout the pregnancy.

Stop Smoking

The exposure to tobacco products in your pregnancy can affect the placenta adversely. Smoking reduces the blood flow to the placenta, leading to a hypoxic environment for the baby. The lack of nutrients and oxygen can cause thinning of the placenta. So, it results in detachment of the placenta from the uterus wall.

High Blood Pressure

When expectant mothers suffer from high blood pressure, it increases their risk of abnormal bleeding between the uterus wall and placenta. You can suffer from hypertension during your pregnancy because of the condition known as pre-eclampsia. It puts you at risk of bleeding and other complications. So, if you have high blood pressure before getting pregnant or during the pregnancy, work with the doctor to monitor the condition closely.

Avoid Abdominal Trauma

Trauma to the abdominal region due to a fall, auto accident or other injuries can result in separation of the placenta from the uterus. You need to seek immediate medical attention to prevent any complication. Always take necessary precaution while traveling. You need to wear a seatbelt while traveling in a car to avoid injury or accident.

Prior Abruption Of Placenta

Women who have suffered the problem in their previous pregnancy, then talk to your doctor. Your doctor can suggest different methods before you conceive to reduce the risk of another abruption.

Conclusion

When women who have completed 37 weeks of pregnancy suffer placental abruption, the baby suffers less health problem compared to the babies born at earlier gestation. When you suffer the separation of the placenta from the uterus, you need to seek immediate medical treatment. Your doctor can suggest methods to prolong your pregnancy and avoid premature birth. Without treatment, the abruption of the placenta can result in fetal death. You have no particular known cause to suffer from the problem. But, women with a high risk of possible abruption of placenta, need to take necessary action to avoid any complications. When you see vagina bleeding during your pregnancy, contact your doctor immediately.

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