Placenta abruptio Health Article

Definition

Placenta abruptio is separation of the placenta (the organ that nourishes the fetus) from the site of uterine implantation before delivery of the fetus.

Alternative Names

Premature separation of placenta; Ablatio placentae; Abruptio placentae; Placental abruption

Causes, incidence, and risk factors

The exact cause of a placetal abruption may be difficult to determine.

Direct causes are rare, but include:

• Abnormally short umbilical cord
• Injury to the belly area (abdomen) from a fall or automobile accident
• Sudden loss in uterine volume (can occur with rapid loss of amniotic fluid or the delivery of a first twin)

Risk factors include:

• Advanced maternal age
• Cigarette smoking
• Cocaine use
• Diabetes
• Drinking more than 14 alcoholic drinks per week during pregnancy
• High blood pressure during pregnancy -- About half of placental abruptions that lead to the baby's death are linked to high blood pressure
• History of placenta abruptio
• Increased uterine distention (as may occur with multiple pregnancies or abnormally large volume of amniotic fluid)
• Large number of prior deliveries

Placenta abruptio, including any amount of placental separation prior to delivery, occurs in about 1 out of 150 deliveries. The severe form, which results in fetal death, occurs only in about 1 out of 500 to 750 deliveries.

Symptoms

• Abdominal pain
• Back pain
• Vaginal bleeding

Signs and tests

Tests may include:

• Abdominal ultrasound
• Complete blood count
• Fibrinogen level
• Partial thromboplastin time
• Pelvic exam
• Prothrombin time

Treatment

Treatment may fluids through a vein (IV) and blood transfusions. The mother will be carefully monitored for symptoms of shock and the unborn baby will be watched for signs of distress, which includes an abnormal heart rate.

An emergency cesarean section may be necessary. If the fetus is very immature and there is only a small placenta rupture, the mother may be kept in the hospital for close observation and released after several days if the condition does not get worse

If the fetus is developed (matured) enough, vaginal delivery may be chosen if there is minimal distress to the mother and child. Otherwise, a cesarean section may be the preferred choice.