Placenta abruptio

Definition

Placenta abruptio is the separation of the placenta (the organ that nourishes the fetus) from its attachment to the uterus wall before the baby is delivered.

Causes

The exact cause of a placental abruption may be hard to determine.

Direct causes are rare, but include:

Risk factors include:

Placental abruption, which includes any amount of placental separation before delivery, occurs in about 1 out of 150 deliveries. The severe form, which can cause the baby to die, occurs only in about 1 out of 800 to 1,600 deliveries.

Symptoms

Exams and Tests

Tests may include:

Treatment

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

An emergency cesarean section may be needed. If the baby is very premature and there is only a small placental separation, the mother may be kept in the hospital for close observation. She may be released after several days if the condition does not get worse and any bleeding stops.

If the fetus is developed enough, vaginal delivery may be done if it is safe for the mother and child. Otherwise, a cesarean section will be done.

Outlook (Prognosis)

The mother does not usually die of this condition. But any of the following increases the risk of death for both the mother and baby:

Fetal distress occurs early in the condition in about half of all cases. Infants who live have a 40-50% chance of complications, which range from mild to severe.

Possible Complications

Excess blood loss can lead to shock and possible death of the mother or baby. If bleeding occurs after the delivery and blood loss cannot be controlled in other ways, the mother may need a hysterectomy (removal of the uterus).

When to Contact a Medical Professional

Call your health care provider right away if:

See your health care provider right away, call your local emergency number (such as 911), or go to the emergency room if you have vaginal bleeding and severe abdominal pain or contractions during your pregnancy. Placental abruption can quickly become an emergency condition that threatens the life of both the mother and baby.

Prevention

Do not drink any alcohol, such as beer and wine. Do not smoke or use recreational drugs during pregnancy. Get early and regular prenatal care.

Recognizing and managing conditions in the mother such as diabetes and high blood pressure also decrease the risk of placental abruption.


Review Date: 11/8/2012
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

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