Most pregnancies go well, nothing serious happens and both mother and baby are healthy and well throughout. However, sometimes things don't go well and the lives of either mother or baby, or both can be jeopardized. In cases where something goes awry in the pregnancy, immediate medical care is of utmost importance.
What is Placental Abruption?
Placental abruption is not common, but it does occur and is a serious complication of pregnancy. During pregnancy, the placenta develops to provide nourishment for the growing baby. If it peels away from the uterine wall, either partially or fully, it is known as placental abruption. The baby can be deprived of vital oxygen and nutrients and the mother can experience severe and heavy bleeding. Left untreated, placental abruption puts both mother and baby at risk. It is an emergency matter and requires immediate medical attention.
Causes and Risk Factors
The exact cause of placental abruption is often elusive. However there are some possible causes that include a trauma or injury to the abdomen, from an accident or fall; the umbilical cord is unusually short; or there may be a rapid loss of amniotic fluid from around the baby.
Various factors come into play with this condition that may increase the risk of placental abruption. If a woman has had it before, the risk for a repeated event is heightened. Women with high blood pressure, whether chronic or associated with pregnancy, are at increased risk. Substance abuse, including smoking as well as drug use, puts a woman at high risk for placental abruption. Blood-clotting disorders or any condition that impairs blood clotting is added to the list. Multiple pregnancies, previous pregnancies and pregnancies in women over the age of 35 are all considered risk factors for placental abruption.
Signs of Placental Abruption
This serious condition can occur any time after 20 weeks of pregnancy. The signs of placental abruption include vaginal bleeding, abdominal pain, back pain, uterine tenderness and rapid uterine contractions, often coming one right after another. The abdominal and back pain is usually sudden onset in nature. Vaginal bleeding can vary greatly and is not always associated with how much the placenta has separated from the wall of the uterus. Sometimes there is no bleeding at all, even though the placental abruption is severe. If any of the symptoms of placental abruption are present, call the doctor immediately.
If left untreated, life-threatening complications can occur to both mother and baby. Maternal shock and premature birth are serious possibilities. The baby may be deprived of oxygen and nutrients, there may be neurological damage to the baby or in the worst case scenario the baby is stillborn. Excessive bleeding is another possible complication of placental abruption. If the bleeding cannot be controlled after the birth of the baby, a hysterectomy may be required.
Possible Treatments Vary with Conditions
Depending upon the circumstances, treating placental abruption is done in a variety of ways. If the abruption seems mild, the baby's heart rate is normal and it is too soon for the baby to be born, close monitoring in the hospital is the first step in treatment. Provided the bleeding stops and the baby's condition is stable, home rest may be prescribed. In the event that early delivery seems necessary, a medication may be administered that hastens the development of the baby's lungs. If the baby is close to full term and the abruption seems minimal, it may be possible to deliver the baby vaginally under close monitoring. Should the abruption progress and either the mother or baby is at risk, an emergency C-section is usually performed. Severe bleeding may necessitate a blood transfusion.
Reducing the Risk of Placental Abruption
Once the placenta has separated from the wall of the uterus, it cannot be reattached. Preventing placental abruption is not possible, but there are ways to reduce the risk of its occurrence. Controlling high blood pressure and other chronic conditions is important. Potential trauma can be reduced by using a seat belt when driving in the car. Smoking, illegal drugs like cocaine and alcohol are all risk factors in placental abruption and should be stopped. If placental abruption has occurred previously in another pregnancy, then talking with the doctor about ways to reduce risk is important.