Date: 18 Mar 2016
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What is placenta abruptio?
Placenta abruptio is a problem with the placenta during pregnancy. The placenta is a round, flat organ that forms during pregnancy to give the baby food and oxygen from the mother. During a normal pregnancy, the placenta stays firmly attached to the inside wall of the uterus until the baby has been born. But with placenta abruptio, the placenta breaks away, or abrupts, from the wall of the uterus too early, before the baby is born. This problem can cause:
Low birth weight.
Major blood loss in the mother.
Placenta abruptio can be very harmful for both the mother and the baby. In rare cases, it can cause death.
Placenta abruptio is also called abruptio placenta or placental abruption. It affects about 9 out of 1,000 pregnancies. It usually occurs in the third trimester, but it can happen at any time after the 20th week of pregnancy.
What causes placenta abruptio, and how can you lower your risk?
Doctors aren't sure what causes placenta abruptio. But there are things that raise a woman’s risk for an abruption. These things are called risk factors. If you avoid them, you can lower your risk.
Common risk factors for placenta abruptio include:
High blood pressure (140/90 or higher). This is the most common risk factor linked to placenta abruptio, whether the high blood pressure is chronic (long-term) or is caused by the pregnancy (preeclampsia).
Having a placental abruption in the past.
Smoking during pregnancy.
Less common risk factors for placenta abruptio include:
Having a scar from a past surgery or a uterine fibroid where the placenta has attached to the wall of the uterus.
Having an injury to the uterus. This could happen in a car accident.
Premature rupture of membranes for 24 hours or more, especially when there is an infection in the uterus.
What are the common symptoms?
If you have placenta abruptio, you may notice one or more warning signs. Call your doctor right away if you are pregnant and have any of these symptoms:
Light or moderate vaginal bleeding. Bleeding caused by an abruption depends on where the abruption is and how long it has taken for the blood to pass.
A uterus that hurts or is sore. It might also feel hard or rigid.
Signs of early labor. These include regular contractions and aches or pains in your lower back or belly.
Call 911 or emergency services right away if you have:
Sudden or severe pain in your belly.
Severe vaginal bleeding.
Any symptoms of shock. These include feeling lightheaded or like you are going faint; feeling confused, restless or weak; feeling sick to your stomach or vomiting; and having fast, shallow breathing.
You can't really tell how serious an abruption is by the amount of vaginal bleeding. There might be a serious problem even if there is only a little bleeding. Sometimes the blood can be trapped between the placenta and the wall of the uterus. In rare cases, symptoms of shock will be the only signs that there is a problem.
How is placenta abruptio diagnosed?
Your doctor will ask questions about your symptoms and will check your baby’s heart rate. You may have an ultrasound test. Your doctor might also do a blood test to see if you're anemic from losing blood.
If your doctor thinks that you have a placental abruption, you'll likely have to stay in the hospital for at least a few hours. Your doctor will need to find out how severe the abruption is, if it is getting worse, and if it is affecting your baby.
How is it treated?
The kind of treatment you will have depends on:
How severe the abruption is.
How it is affecting your baby.
How close your due date is.
If you have a mild abruption, it may get better on its own. You may just be closely watched for the rest of your pregnancy. You may not have to stay in the hospital.
A medium to severe abruption means that you will likely have to stay in the hospital so that the baby's health can be watched closely. In most cases, the baby will need to be delivered, sometimes by emergency cesarean section.