Placental Abruption
Placenta separates from uterine wall before delivery - emergency requiring immediate delivery.
Affects: 1% of pregnancies
Overview
Placental abruption occurs when the placenta partially or completely separates from the uterine wall before delivery. This is a medical emergency because the baby depends on the placenta for oxygen and nutrients.
Symptoms include vaginal bleeding, abdominal pain, and uterine contractions. However, bleeding may be hidden behind the placenta. The condition can progress rapidly and requires emergency delivery.
Severe abruption can cause massive bleeding, shock, and fetal death. Even mild abruption requires close monitoring as it can worsen suddenly. Emergency C-section is often necessary.
🩺 Symptoms
- •Vaginal bleeding (may be heavy or light)
- •Abdominal pain
- •Back pain
- •Uterine tenderness
- •Rapid uterine contractions
- •Uterus that stays hard between contractions
- •Decreased fetal movement
- •Fetal distress on monitoring
- •Hidden bleeding (no visible bleeding)
🔍 Causes
- →Exact cause often unknown
- →Trauma to abdomen (car accident, fall, abuse)
- →Sudden decrease in uterus size (after water breaks)
- →Blood vessel problems
- →Hypertension
- →Cocaine use
⚠️ Risk Factors
- •High blood pressure or preeclampsia
- •Previous placental abruption (10% recurrence)
- •Abdominal trauma
- •Smoking
- •Cocaine or methamphetamine use
- •Heavy alcohol use
- •Multiple pregnancy
- •Age over 35
- •Premature rupture of membranes
- •Polyhydramnios (excess amniotic fluid)
- •Short umbilical cord
- •Uterine infection
- •Previous C-section
🔬 Diagnosis
- →Physical exam showing tender, hard uterus
- →Vaginal bleeding
- →Fetal heart rate abnormalities
- →Ultrasound (may not show abruption)
- →Blood tests checking for anemia and clotting
- →Diagnosis often based on symptoms
💊 Treatment
- ✓Mild (small separation, stable): Close monitoring, possible bed rest
- ✓Moderate to Severe: Immediate delivery
- ✓Emergency C-section if baby or mother in distress
- ✓Blood transfusions if severe bleeding
- ✓IV fluids
- ✓Oxygen
- ✓Continuous fetal monitoring
- ✓Corticosteroids if preterm and stable enough to wait
- ✓Cannot reattach placenta - delivery only treatment
🛡️ Prevention
- →Cannot always be prevented
- →Control blood pressure
- →Avoid smoking, alcohol, drugs
- →Wear seatbelt properly
- →Avoid abdominal trauma
- →If previous abruption, extra monitoring
⚠️ Potential Complications
- !Fetal death
- !Severe maternal bleeding
- !Shock
- !DIC (disseminated intravascular coagulation)
- !Kidney failure
- !Hysterectomy
- !Maternal death
- !Brain damage if baby deprived of oxygen
- !Preterm delivery complications
🚨 When to Call Your Doctor
Contact your healthcare provider immediately if you experience:
- ⚠Any vaginal bleeding in second or third trimester
- ⚠Abdominal pain
- ⚠Back pain
- ⚠Uterine tenderness or contractions
- ⚠Decreased fetal movement
- ⚠After any trauma to abdomen
- ⚠Call 911 if heavy bleeding or severe pain
- ⚠This is an emergency - go to hospital immediately
Related Conditions
This information is for educational purposes and should not replace medical advice. Always consult your healthcare provider for personalized guidance.