Placenta abruptio


Abruptio placentae

Description, Causes and Risk Factors:

Placental abruption (also known as abruptio placentae) is a complication of pregnancy, wherein the placental lining has separated from the uterus of the mother. It is the most common pathological cause of late pregnancy bleeding. In humans, it refers to the abnormal separation after 20 weeks of gestation and prior to birth. It occurs in 1% of pregnancies worldwide. Placental abruption is a significant contributor to maternal mortality worldwide; early and skilled medical intervention is needed to ensure a good outcome, and this is not available in many parts of the world.

The exact cause of a Placenta abruptio may be hard to determine.

Direct causes are rare, but include:

Injury to the belly area (abdomen) from a fall, hit to the abdomen, or automobile accident.

Sudden loss of uterine volume (can occur with rapid loss of amniotic fluid or after a first twin is delivered).

Other risk factors may include:

    Blood clotting disorders (thrombophilia).

  • 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).

  • Large number of past deliveries.

  • Older mother.

  • Premature rupture of membranes (the bag of water breaks before 37 weeks into the pregnancy).

  • Uterine fibroids.

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:

Symptoms may include the following:

    Abdominal pain.

  • Back pain.

  • Frequent uterine contractions.

  • Uterine contractions with no relaxation in between.

  • Vaginal bleeding.

Diagnosis:

Diagnosis may include the following tests:

    Abdominal ultrasound.

  • Complete blood count (CBC).

  • Fetal monitoring.

  • Fibrinogen level.

  • Partial thromboplastin time.

  • Pelvic exam.

  • Platelet count.

  • Prothrombin time.

  • Vaginal ultrasound.

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.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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