Pregnancy is full of ups-and-downs: You might be feeling relatively safe since there aren’t any major problems with your pregnancy especially if you’ve entered the second trimester. However, complications can arise, and one is placental abruption (abruptio placentae). Placental abruption takes place in less than or about 1% of pregnancies.1It’s abrupt, but let’s get right down to the definition of placental abruption, the symptoms, the causes, treatment methods and the actions you can take to prevent it from happening.
What is placental abruption?
Let’s start with the placenta: It is through the placenta that the baby gets all the nutrients and the oxygen necessary for growth. The placenta usually detaches itself from the uterine lining 15 to 30 minutes after the birth – it’s expelled from the vagina after the baby is delivered. However, there are instances in which the placenta becomes separated from the lining even though the baby is still in the uterus. This is placental abruption (abruptio placentae).
Placental abruption: Risk to mother and baby
Once the placenta is separated from the uterine lining, transport of oxygen to the fetus stops, resulting in fetal death. The risk to the fetus depends on the area of the part of the placenta that has peeled away. If a large area of the placenta peels away abruptly and if it takes too long to reach the hospital, fetal distress might be too great and even a delivery and resuscitation after might not guarantee that the baby is completely safe – there are instances in which babies are born with cerebral palsy or other growth issues.
When a placental abruption happens, retroplacental hemorrhage can also occur. Retroplacental hemorrhage refers to bleeding that occurs behind the placenta. In order to stop the bleeding, your body will work to make the blood clot.
However, disseminated intravascular coagulation (DIC), a condition “in which proteins that control blood clotting become overactive” and produce too many small blood clots throughout the blood vessels. DIC can clog the vessels of the liver, kidneys and other organs in the body, and if placental abruption happens, the shock to the body caused by a large amount of blood loss can result in DIC. This not only poses a risk to the mother, the fetus will be grave danger as well.
According to a research on placental abruption by the National Center for Biotechnology Information, U.S. National Library of Medicine in 2006, in cases where more than 50% of the placenta peels off, there is a high possibility that will result in fetal death.2
Symptoms of placental abruption
Symptoms differ from individual to individual, as do the severity and the progression of the symptoms. In worst-case scenarios, the expecting mother feels immobilized by strong, sudden abdominal pain and back pain, experience tightening in the abdominal regions, or experience bleeding. Also, fetal movement becomes weaker or completely stops.
In cases that are not as serious, there might be no bleeding, no abdominal pain nor back pain that feels a little strange to you. A physical examination and an ultrasound might not always be able to diagnose a placental abruption accurately. Follow up with fetal monitoring tests as abnormalities in fetal heart rate is one indication that not all is well. Make sure you get yourself checked at your practitioner’s right away if you feel that something is amiss.
Causes of placental abruption
Direct causes of placental abruption aren’t yet known, but the followings have been thought to be indirect causes:
- Gestational hypertension or preeclampsia
- Chorioamnionitis: inflammation of the fetal membranes
Complications arising from nephritis, graves’ disease (hyperthyroidism) and fibroids
Fetal malformation, intrauterine growth restriction (IUGR)
A medical history of placental abruption
Use of tobacco
Injury on or shock to the abdominal region
Use of cocaine
Diagnosis and treatment for placental abruption
As there are no clear symptoms that indicate that placental abruption has taken place, it’s difficult to diagnose or treat it. If there are abnormalities in fetal heart rate or if through an ultrasound, an abnormally enlarged placenta is observed, the practitioner will recommend hospitalization or bed rest.
Placental abruption: Treatment
Once the placenta peels away from the uterine lining, the baby can no longer stay in the uterus and must be delivered as soon as possible – so this often ends with a caesarean section. As vaginal bleeding is usually profuse and doesn’t stop, this can endanger the life of the fetus, so there is no other choice.
When the placental abruption is classified as partial, the placenta is able to function as normal. Though there is no need for a caesarean section, the mother is usually required to be hospitalized. From Week 34, the fetus is more or less ready to be delivered, so if the placenta is not functioning well and the risk posed to the fetus by the placental abruption outweighs the complications of being born premature, then a caesarean section will be recommended.
As a placental abruption isn’t a situation to be taken lightly, self-diagnosis is forbidden – go to the hospital immediately!
Prevention tips for placental abruption
- Diligently going to the practitioner’s and getting yourself checked
Managing blood pressure
Getting yourself checked after suffering an impact to the abdominal area
Don’t tarry and seek speedy treatment for placental abruption
Speedy treatment or emergency measures like a caesarean section is vital in minimizing the effects on the fetus and mother when placental abruption occurs. When your expected delivery date approaches, contractions might occur, and because the contractions might be the strongest and most painful you’ve ever experienced thus far, it might be difficult to differentiate between normal contractions and the contractions and pain arising from a placental abruption.
Remember that the contractions from a placental abruption are not only strong, the pain doesn’t cease and instead suddenly becomes more severe. Although the onset of pain might be very abrupt, monitor your condition calmly and contact your practitioner immediately if you suspect these aren’t the usual contractions! Remember that each and every second means life-or-death to your baby!