Definition

Placental abruption occurs when the placenta separates from the uterus before the fetus is delivered. The placenta is the organ that provides nourishment for the fetus while it is still in the uterus. In a healthy pregnancy, the placenta remains attached to the uterine wall until after the fetus is delivered.

Some form of the condition affects about one in every 150 births. In very severe forms, placental abruption can cause death to the fetus. This occurs in approximately one in every 500-750 deliveries. Death of the mother from placental abruption is very rare. Infants who survive a birth with the condition have a 40%-50% chance of experiencing complications.

Placental abruption can cause:

• Premature delivery
• Low birth weight
• Significant blood loss for the mother

Placental Abruption

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Causes

The cause of placental abruption is often difficult to diagnose. Some common causes of the condition include:

• Injury to the abdomen from an accident or a fall
• Sudden decrease in the volume of the uterus, from significant loss of amniotic fluid or from the delivery of a first twin
• Abnormally short umbilical cord
• Acute development of high blood pressure (often associated with cocaine use)

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. The following factors increase your chance of developing placental abruption:

• Previous placental abruption in a prior pregnancy
• High blood pressure during pregnancy
• Pregnancy during older age
• Multiple previous deliveries (greater than average number)
• Excessively distended uterus
• Diabetes
• Drug use (cocaine)
• Smoking during pregnancy
• Alcohol abuse during pregnancy

Symptoms

In the early stages, you may not have symptoms. When symptoms occur, they may include:

• Vaginal bleeding
• Abdominal pain
• Back pain
• Rapid contractions
• Soreness in the uterus

Diagnosis

Your doctor will ask about your symptoms and medical history, and do a physical exam.

Tests may include the following:

• Pelvic examination
• Ultrasound —a test that uses sound waves to examine the abdomen
• Blood coagulation profile—a test to measure how long it takes for your blood to clot

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Prevention

To help reduce your chance of getting placental abruption, take the following steps:

• Avoid taking drugs, drinking alcohol, and smoking during pregnancy.
• Receive proper and regular prenatal care throughout the pregnancy.
• Promptly treat conditions, including diabetes and high blood pressure.