What Is Placenta Abruptio?

J.M. Willhite

Placenta abruptio is a pregnancy complication that compromises the health of the mother and her unborn child. Substance abuse, hypertension, and age are common contributing factors that can initiate the premature separation of the placenta from the uterine wall in some women. Depending on how far along the woman is in her pregnancy, treatment can range from watchful waiting to premature delivery. To minimize risk for placenta abruptio, women are encouraged to refrain from engaging in activities that may place their pregnancy at risk, such as using illicit drugs and smoking.

A pregnant woman may experience abdominal discomfort as a result of placenta abruptio.
A pregnant woman may experience abdominal discomfort as a result of placenta abruptio.

There is no definitive cause for placenta abruptio, also known as placental abruption. Under normal circumstances, the placenta remains attached to the uterine wall until after a baby is delivered. Commonly referred to as “afterbirth,” the placenta detaches following delivery and is expelled through the vagina.

Placenta abruptio that places mother and baby at risk may require an immediate C-section.
Placenta abruptio that places mother and baby at risk may require an immediate C-section.

Medical organizations, such as the Mayo Clinic, suggest biological factors directly linked to pregnancy, such as anomalous umbilical formation, may initiate premature placental separation. Abdominal trauma, as can occur with a fall, may also contribute to placenta abruptio. Other factors that may trigger placental separation can include uterine infection, preeclampsia, and a history of placenta abruptio with previous pregnancies.

Premature infants may remain in the NICU for days or even weeks before they are stable enough to be held by their parents.
Premature infants may remain in the NICU for days or even weeks before they are stable enough to be held by their parents.

Women with suspected placenta abruptio are generally admitted into the hospital for observation while their condition is thoroughly evaluated. Imaging and laboratory tests are usually conducted to confirm a diagnosis. Ultrasound is frequently used to identify the location and extent of placental separation. Depending on her condition, the mother may remain hospitalized until the child is delivered.

Vaginal ultrasound probes may be inserted into the vagina to obtain an image of the uterus.
Vaginal ultrasound probes may be inserted into the vagina to obtain an image of the uterus.

Placenta abruptio may or may not be accompanied by vaginal bleeding. The mother may experience abdominal discomfort that radiates around to her back. It is not uncommon for placental separation to also instigate contractions and other signs indicating labor. If symptoms are ignored, life-threatening complications can develop. Not only may the mother go into shock, but the baby may suffer oxygen deprivation or be stillborn.

Substance abuse can cause placenta abruptio.
Substance abuse can cause placenta abruptio.

If a mother suffers placental abruption early in her pregnancy, medication may be given to prevent her from going into labor. Minimal placental separation that poses no immediate risk to mother or baby usually necessitates close monitoring and restriction of the mother’s physical activity. Placenta abruptio that places mother and baby at risk for complication can require immediate cesarean (C-section) delivery. Premature infants born with significant health issues are usually placed in the neonatal intensive care unit (NICU) until their condition may be stabilized and they are mature enough to function without artificial support.

The placenta develops inside of the uterus during pregnancy.
The placenta develops inside of the uterus during pregnancy.
Preeclampsia may trigger placenta abruptio.
Preeclampsia may trigger placenta abruptio.

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