What Is a Placental Abruption?
Placental abruption (abruptio placentae) is a pregnancy complication that occurs when the placenta separates from your uterus before delivery. The placenta is a temporary organ that connects a developing fetus to your uterus during pregnancy. It attaches to the wall of your uterus, usually on the top or side, and acts as a lifeline that gives nutrients and oxygen to the fetus through the umbilical cord. The placenta also removes waste from the fetus’s blood.
In placental abruption, the placenta may detach completely or partially. This can reduce the amount of oxygen and nutrients the fetus receives. It can also cause heavy bleeding in the birthing parent. Your doctor will need to monitor you closely and determine if an early delivery is necessary.
What Are the Different Types of Placental Abruption?
Your doctor will classify the abruption based on how much the placenta detaches from your uterus:
. A partial placental abruption occurs when the placenta does not completely detach from the uterine wall.
. A complete or total placental abruption occurs when the placenta completely detaches from the uterine wall. There is usually more vaginal bleeding with a complete abruption.
They will further classify it by how much you are bleeding:
. Revealed placental abruptions have moderate to severe vaginal bleeding that you can see.
. Concealed placental abruptions have little or no visible vaginal bleeding. Blood is trapped between the placenta and uterine wall.
Signs and Symptoms of Placental Abruption
Each person may have different symptoms of placental abruption. But the most common symptom is vaginal bleeding with cramping during the third trimester of pregnancy. Other symptoms include:
. Abdominal pain.
. Uterine tenderness.
. Feeling the fetus move less.
. Backache or back pain.
. Uterine contractions that are longer and more intense than normal labor contractions.
Vaginal bleeding can vary and is not an indication of how severe the abruption is. In some cases, the bleeding is not visible because the blood is trapped between the placenta and the uterine wall. Pain can range from mild cramping to strong contractions that come on suddenly.
These symptoms can be similar to other pregnancy conditions. Contact your doctor if you experience vaginal bleeding and cramping.
What Are the First Signs of a Placental Abruption?
The most common symptom of a placental abruption is vaginal bleeding, although you won’t always have bleeding. You may also have sudden, persistent pain in your abdomen or back.
What Causes Placental Abruption?
The cause of placental abruption is often unknown. Doctors only know what increases the risk of an abruption. For example, abdominal trauma from a fall or accident, can increase the risk for placental abruption.
How Is a Placental Abruption Diagnosed?
Your doctor will diagnose placental abruption through an exam and other tests. Depending on the severity of the abruption, you may be hospitalized or you may be able to rest at home. Your doctor will:
. Ask where you feel pain and how intense the pain is.
. Ask how much bleeding has occurred.
. Ask when symptoms started.
. Monitor your contractions.
. Monitor your blood pressure.
. Monitor the fetal heart rate and movement.
. Recommend urine or blood tests.
. Use ultrasound to locate the bleeding and to check the fetus.
There are usually three grades, or classes, of placental abruption a doctor will diagnose:
. Grade 1: Small amount of bleeding, some uterine contractions and no signs of stress to you or the fetus. This is usually a mild or partial placental abruption, meaning that only part of the placenta is detached.
. Grade 2: Mild to moderate amount of bleeding, some uterine contractions and possible signs of fetal distress.
. Grade 3: Moderate to severe bleeding or concealed bleeding, uterine contractions that do not relax, abdominal pain, low blood pressure and potential fetal death.
What Are the Risk Factors for Placental Abruption?
The following factors increase the risk of placental abruption:
. Previous placental abruption.
. Trauma or injury to your uterus (like a car accident, fall or blow to the stomach).
. High blood pressure (hypertension), gestational diabetes or preeclampsia.
. Multiple gestations (pregnant with more than one fetus).
. Being older than 40.
. Uterine fibroids.
. If you smoke or use recreational drugs.
. Thrombophilia (a blood clotting disorder).
. Chorioamnionitis (an infection in your amniotic fluid).
. Premature rupture of membranes (your water breaks before the fetus is fully formed) or losing too much amniotic fluid.
What Are Complications of Placental Abruption?
Placental abruption can be life-threatening to the fetus and, sometimes, to you. Complications of a placental abruption include:
For the fetus:
. Low birth weight.
. Premature birth.
. Brain injury from lack of oxygen.
. Stillbirth.
. Growth problems (intrauterine growth restriction).
For the birthing parent:
. Blood clotting issues.
. Anemia.
. Blood transfusion.
. Kidney failure.
. Hemorrhage.
How Is a Placental Abruption Treated?
Once the placenta has separated from the uterus, it cannot be reattached or repaired. A doctor will recommend treatment based on:
. How long the pregnancy is/gestational age of the fetus.
. The severity of the abruption.
. Amount of blood you’ve lost.
. Signs of distress from the fetus.
In general, the severity of the abruption and gestational age of the fetus are the two most important factors in determining treatment.
If the fetus isn’t close to term:
. If it is too early for the fetus to be born and your abruption is mild, your doctor will monitor you closely. You may go home to rest, or you may stay in the hospital. Your doctor may give you corticosteroids to help the fetus’s lungs mature. They will continue to monitor you.
. If the abruption is severe and the health of you or the fetus is at risk, immediate delivery may be necessary even if the fetus is not close to term (37 weeks of pregnancy).
If the fetus is near term:
. If the abruption is mild and the fetal heart rate is normal, your doctor may allow your pregnancy to continue to term. They may give you corticosteroids to mature the fetus’s lungs and monitor you closely for changes.
. If the abruption is severe, immediate delivery may be required. If you or the fetus is in danger at any time, the baby will be delivered (usually by emergency C-section).
You may need to give birth if any of the following occur (regardless of the age of the fetus):
. You’re bleeding heavily or develop severe anemia.
. The abruption gets severe/worsens.
. The fetus is in distress and showing signs it lacks oxygen.
How Do You Treat a Mild Placental Abruption?
Even if the abruption is mild, your doctor will consider the gestational age of the fetus in their treatment plan. For example, if you’re at term, they may still recommend inducing labor. If you’re still months away from your due date, your doctor may consider a different approach, even for a mild abruption. In general, the pregnancy can continue to term unless the abruption or bleeding worsens, or the fetus shows signs of being in trouble
How Do You Treat a Severe Placental Abruption?
A severe abruption is usually a medical emergency because both the fetus and birthing parent are at risk for life-threatening complications. Delivery usually occurs immediately.
Can I Prevent a Placental Abruption?
You usually cannot prevent placental abruption. But you can reduce your risk by:
. Keeping your blood pressure at a healthy level.
. Not smoking or using recreational drugs. Talk to your doctor before taking any medication during pregnancy.
. Managing chronic health conditions.
. Reporting any abdominal trauma or vaginal bleeding to your doctor.
. Taking health and safety precautions like wearing a seat belt.
FAQ:
- What Does Placental Abruption Feel Like?
You may experience sudden or severe pain, cramping or tenderness in your lower pelvic area or back during a placental abruption. You can also feel less fetal movement. Discuss these symptoms with your doctor immediately.
- How Common Is a Placental Abruption?
Placental abruption occurs in about 1 out of 100 pregnancies (1%).
- Can a Baby Survive a Placental Abruption?
The two factors that affect survival rate are gestational age at birth and the severity of the abruption. Early diagnosis, careful monitoring and prompt treatment can help reduce complications. If a severe abruption occurs, there is about a 15% chance of fetal death.
- Can Sneezing Cause a Placental Abruption?
Sneezing is a normal thing your body does and won’t cause a placental abruption. It cannot harm the fetus in any way. If you are concerned about frequent and severe sneezing or coughing, call your doctor.
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Can Sex Cause a Placental Abruption?
Sexual intercourse is not the direct cause of placental abruption. In most cases, having sex during pregnancy is completely safe. During pregnancy, you should avoid activities with a high risk of falling or abdominal trauma.
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Can Smoking Cause a Placental Abruption?
Smoking can increase the risk of many complications during pregnancy, including placental abruption. Ask your doctor about ways to quit smoking.
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What Can I Expect If I Have a Placental Abruption?
This can vary depending on the severity of your symptoms and how far along you are in your pregnancy. You can expect for your doctor to monitor you closely and often. Watch for any changes in symptoms and discuss them with your doctor right away.
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What Week Is Placental Abruption Most Common?
Placental abruption mostly occurs later in the third trimester, which starts around 28 weeks of pregnancy and continues until delivery (around 40 weeks). But it can happen any time after 20 weeks.
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Do You Always Bleed During a Placental Abruption?
Most of the time, you’ll see some blood during a placental abruption. But if the abruption is concealed, the blood will be trapped behind the placenta. In this case, there will be no bleeding. In other cases, the abruption develops slowly, which can cause occasional, light bleeding.
Talk to your doctor about any vaginal bleeding you experience during your pregnancy.
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Can Pushing on Your Belly Cause Placental Abruption?
Pushing on your abdomen, like when your doctor pushes on your abdomen during prenatal appointments, doesn’t cause a placental abruption. But a blow to your abdomen (such as in a car accident or falling down the steps) can cause the placenta to detach.
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Can a Bumpy Ride in a Car Cause Placental Abruption?
No, a bumpy ride in a vehicle, bus or plane is not one of the causes of placental abruption. But your doctor asks you to avoid any activity that involves the risk of falling or abdominal trauma. This can include things like horse riding or roller coaster.
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Can I Have Another Placental Abruption?
You have about a 15% chance of having another abruption in a future pregnancy after you have one. With two prior abruptions, this chance increases to about 25%. Tell your doctor if you have ever had a placental abruption.
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What Is the Difference Between Placental Abruption and Placenta Previa?
Placenta previa is when the placenta blocks all or part of your cervix. It is also called low-lying placenta. Think of it as an obstacle that’s blocking the exit from the uterus. Even though the placenta is in a complicated position, it is still attached to your uterus. A placental abruption occurs when the placenta detaches from the uterus. Both conditions can cause vaginal bleeding during pregnancy and delivery.
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When Do I Call My Healthcare Provider If I Suspect a Placental Abruption?
Call your doctor immediately if you’re bleeding, cramping or experiencing pelvic pain during your pregnancy, especially in the third trimester.
Source:
. https://my.clevelandclinic.org/health/diseases/9435-placental-abruption
Read more about: Subchorionic Hematoma
Source:
. https://my.clevelandclinic.org/health/diseases/9435-placental-abruption