Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Placental Abruption

(Premature Separation of Placenta; Ablatio Placentae; Abruptio Placentae)
Pronounced: pluh-SEN-tul ab-RUP-shun
by Diana Kohnle
Definition

Placental abruption occurs when the placenta separates from the uterus before the fetus is delivered. The placenta is the organ that provides nourishment for the fetus while it is still in the uterus. In a healthy pregnancy, the placenta remains attached to the uterine wall until after the fetus is delivered.

Some form of the condition affects about one in every 150 births. In very severe forms, placental abruption can cause death to the fetus. This occurs in approximately one in every 500-750 deliveries. Death of the mother from placental abruption is very rare. Infants who survive a birth with the condition have a 40%-50% chance of experiencing complications.

Placental abruption can cause:

Causes

The cause of placental abruption is often difficult to diagnose. Some common causes of the condition include:

  • Acute development of high blood pressure (often associated with cocaine use )
  • Abnormally short umbilical cord
  • Injury to the abdomen from an accident or a fall
  • Sudden decrease in the volume of the uterus, from significant loss of amniotic fluid or from the delivery of a first twin
Risk Factors

The following factors increase your chance of developing placental abruption:

Symptoms

In the early stages, you may not have symptoms. When symptoms occur, they may include:

  • Abdominal pain
  • Back pain
  • Rapid contractions
  • Soreness in the uterus
  • Vaginal bleeding
Diagnosis

Your doctor will ask about your symptoms and medical history, and do a physical exam.

Tests may include the following:

  • Blood coagulation profile—a test to measure how long it takes for your blood to clot
  • Pelvic examination
  • Ultrasound —a test that uses sound waves to examine the abdomen
Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Intravenous Treatments

Fluids may be administered intravenously (through a vein in your arm) to replace lost fluids. Blood transfusions may also be given to replace lost blood supply.

The mother and fetus will be carefully monitored for signs of distress or shock , including abnormal heart rates.

Emergency Cesarean Delivery

If danger exists for mother or fetus, an emergency Cesarean delivery may be done. If both the mother and fetus are at low risk of complications and the fetus is full-term, the mother may deliver vaginally .

Prevention

To help reduce your chance of developing placental abruption, take the following steps:

  • Promptly treat conditions, including diabetes and high blood pressure .
  • Avoid taking drugs (especially cocaine), drinking alcohol, and smoking during pregnancy.
  • Receive proper and regular prenatal care throughout the pregnancy.

Last reviewed: December 2011 by Ganson Purcell Jr., MD, FACOG, FACPE.

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