Placental abruption or Abruptio Placentae is a serious medical condition and generally requires emergent medical attention. Although it is an uncommon condition but due to its life threatening potential it is always advisable to
seek medical help as soon as possible. Placenta or baby cord is the tissue which joins the baby with mother?s womb and is very important as the fetus will get his nutrition through this placenta only while he is inside the mother?s womb.
Placental abruption or Abruptio Placentae is a serious medical condition and generally requires emergent medical attention. Although it is an uncommon condition but due to its life threatening potential it is always advisable to seek medical help as soon as possible. Placenta or baby cord is the tissue which joins the baby with mother’s womb and is very important as the fetus will get his nutrition through this placenta only while he is inside the mother’s womb. If this placenta is detached from the womb or the uterine wall prematurely then the condition is referred to as Abruptio Placentae. The term generally refers to the detachment of placenta from the uterine wall after the 20th week of gestation and prior to birth. It is one of the common causes of bleeding in the second half of pregnancy. Placenta can partially or fully detach from the uterus depending on the etiology. As placental abruption can lead to severe bleeding and also the oxygen and nutrient supply to the fetus is affected, the condition compromises both the mother and the baby.
Signs and Symptoms
- Bleeding per vaginal
- Severe pain in lower abdomen
- Pain in back
- Increased uterine activity resulting in rapid uterine contractions
- Uterine area is tender to touch
- There may be concealed hemorrhage
- Decreased fetal movement may be due to fetal death
- Signs of shock
Complications
- Renal failure
- Disseminated intravascular coagulation
- Maternal death
- Fetal death
- Post partum hemorrhage
- Hysterectomy may be considered in some cases
- If fetus is delivered then it may have low blood pressure
- Brain damage to the baby
- Mother may suffer severe shock which may affect various organs
Causes and risk factors
- Mother having hypertension
- Accidental trauma to mother like sharp blow, motor accident etc
- Retroplacental fibromyoma
- Short cord
- Prolonged rupture of membranes
- Cigarette smoking and other form of tobacco abuse
- Maternal age of 30 years or older
- Low socioeconomic status
- Low socioeconomic status
- Needle puncture during amniocentesis
- Infections
- Uterine abnormalities
Diagnosis and Investigations
- Blood tests
- Symptoms of the patient
- Fetal Monitoring
- Ultrasound of Pelvis
- Pelvic Examination
Treatment and Drugs
- Intravenous fluids to correct hypovolemia
- Blood transfusion to correct low hemoglobin
- Fetal external electronic monitoring to detect fetal distress
- Maintaining vitals and monitoring for signs of shock
- Fetal heart monitoring
- Antibiotics to either treat or prevent infections
- Steroids may be used in some cases and are useful in reducing the inflammation in the baby’s lungs
- Drugs are given to control uterine contractions in some cases known as tocolytics
- If possible delivery or hysterectomy may be sought in some cases as life saving measures.