Placental abruption is a complication of pregnancy that can occur after the 20th week. This complication occurs when the placenta detaches from the uterus earlier than it would in a normal pregnancy. Placental abruption also is called abruptio placentae and, less commonly, placenta previa abruptio. This condition can be fatal for the woman or the fetus if it is not treated promptly.
The placenta is a temporary organ that develops during pregnancy and serves as a physical connection between a woman and the fetus she carries. The primary function of the placenta is to provide a point of exchange through which nutrients and oxygen are transferred from the woman to the fetus and through which waste products are transferred from the fetus to the woman. In a healthy pregnancy, the placenta begins to form when the fertilized egg implants itself into the uterus, and it does not detach until very shortly before birth.
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Placental abruption occurs for reasons that are not well understood, but there are some known risk factors. Diseases such as diabetes, arthritis, heart disease and hypertension can increase the risk. Women who smoke, abuse alcohol or use cocaine also have an increased risk of placental detachment. Other possible causes include traumatic injuries of the kind that might occur in a traffic accident or a fall.
The risk of fetal or maternal mortality from placental abruption is low, as long as medical treatment is obtained quickly. This condition does have the potential to be fatal if not treated, however, so a pregnant woman should not hesitate to seek emergency medical treatment if she experiences any symptoms. The following symptoms can indicate placental detachment: uterine cramps, uterine contractions, vaginal bleeding, back pain and abdominal pain.
Tests used to diagnose placental abruption typically include blood tests and an ultrasound. Blood tests are used to check for levels of blood clotting factors and other blood products such as hemoglobin and platelets in order to determine whether abnormal bleeding is occurring. An ultrasound is conducted to confirm the location of the placenta and to exclude other conditions from the diagnosis.
When only a small amount of placental detachment occurs, a woman might not need to spend time in hospital, but she often will require bed rest until the danger of full detachment has passed. Some women need to be hospitalized for treatment such as blood volume replacement and monitoring of fetal health. The objective of treatment generally is to maintain the pregnancy for as long as possible, to ensure that the fetus is mature enough to survive after birth.