Home > Your Health > Conditions A-Z > Placental Abruption

Placental Abruption by Diana Kohnle

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

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)
Cigarette smoking during pregnancy
Alcohol abuse during pregnancy (more than 14 drinks per week during the pregnancy)

Symptoms

Symptoms include:

(In early stages, no symptoms may be present)

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

Diagnosis

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

Tests may include the following:

Pelvic examination
Ultrasound —a test that uses sound waves to examine the abdomen
Blood tests
- Prothrombin time test—tests time it takes for the plasma in the blood to clot
- Partial thromboplastin time test—tests time it takes for the blood to clot
- Fibrinogen test—tests blood levels of a protein that helps blood to clot

Treatment

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

Intravenous Treatments

Fluids may be administered intravenously to replace lost fluids. Blood transfusions may also be given to replace lost blood supply.

The mother and fetus will be carefully monitored for signs of distress or shock , including abnormal heart rates.

Emergency Cesarean Delivery

If danger exists for mother or fetus, an emergency Cesarean delivery may be performed. If both the mother and fetus are at low risk of complications and the fetus is full-term, the mother may deliver vaginally.

Prevention

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

Avoid drugs (especially cocaine), alcohol, and smoking during pregnancy.
Receive proper and regular prenatal care throughout the pregnancy.
Promptly treat conditions in the mother, including diabetes and high blood pressure.

RESOURCES:

The American College of Obstetricians and Gynecologists http://www.acog.org
American Pregnancy Association http://www.americanpregnancy.org
March of Dimes http://www.marchofdimes.com

CANADIAN RESOURCES:

British Columbia Ministry of Health http://bchealthguide.org
The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org/index_e.asp

References:

Bleeding in pregnancy, placenta previa, placental abruption. High-risk pregnancy. Lucile-Packard Children's Hospital website. Available at: http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/hrpregnant/bleed.html . Accessed July 2, 2007.
Placenta abruptio. Medline Plus Medical Encyclopedia. US National Library of Medicine website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000901.htm . Accessed July 2, 2007.
Pregnancy: placental abruption. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/placental-abruption/DS00623/DSECTION=1 . Accessed July 2, 2007.

Last reviewed November 2008 by Jeff Andrews, MD, FRCSC, FACOG

All EBSCO Publishing proprietary, consumer health and medical information found on this site is accredited by URAC. URAC's Health Web Site Accreditation Program requires compliance with 53 rigorous standards of quality and accountability, verified by independent audits. To send comments or feedback to our Editorial Team regarding the content please email us at HLEditorialTeam@ebscohost.com.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.