Accidental Hemorrhage - Placenta Abruptio
- Overview, Causes, & Risk Factors
- Symptoms & Signs
- Diagnosis & Tests
- Prevention & Expectations
- Treatment & Monitoring
Overview, Causes, & Risk Factors
Placenta abruptio during pregnancy is a condition in which the placenta, also known as the afterbirth, separates from the womb before the fetus is born. The placenta is a disc-shaped organ that provides nourishment and blood to a fetus. This most common form of this condition occurs in about 1 out of 150 deliveries. The severe form occurs in only 1 out of 500 to 750 births.
What is going on in the body?
In the normal birthing process, the placenta does not detach from the womb until after the infant is born. In placenta abruptio, blood vessels rupture and create a mass of blood, also called a hematoma. This hematoma shears off the blood vessels next to it, creating further bleeding and separation of the placenta.
There are two kinds of placenta abruptio, relating to where the bleeding occurs:
What are the causes and risks of the condition?
It may not be easy to tell what caused placenta abruptio. In fact, doctors can detect an exact cause in less than 5 out of 100 cases. Some causes (though rare) can include:
However, a woman is more at risk for this condition if she:
Symptoms & Signs
What are the signs and symptoms of the condition?
Symptoms may vary, depending on:
Thirty percent of placenta abruptios are small and produce no symptoms. When the case is severe, symptoms may include:
This condition is sometimes confused with placenta previa.
Diagnosis & Tests
How is the condition diagnosed?
A woman's doctor will look at her medical history and consider any symptoms. He or she also will look for any signs of fetal distress and for tenderness or increased tightness over the uterus. Based on this information, the provider may suspect placenta abruptio.
The diagnosis can be confirmed if:
Prevention & Expectations
What can be done to prevent the condition?
Women can reduce their risk factors by:
Good prenatal care will help to identify pregnancy risk factors and possibly allow for early detection of placenta problems. This will mean that treatment can be started right away.
What are the long-term effects of the condition?
This condition can result in:
However, these results are rare. Maternal death occurs in less than 5 out of 100 women who have placenta abruptio. Fetal death rates are higher. The infant may die in as many as 20 to 35 percent of cases.
What are the risks to others?
This condition can be harmful to the fetus. The woman also has a higher risk of developing this condition during future pregnancies.
Treatment & Monitoring
What are the treatments for the condition?
This condition is usually an emergency and requires treatment right away. Measures will be taken to keep the mother and infant healthy. This might include:
What are the side effects of the treatments?
Because the treatments for this condition may be life-saving, the potential side effects should be weighed against the loss of life. It may take longer for a woman to recover from major abdominal surgery involved in a cesarean section. Risks for any surgery include bleeding, infection, and allergic reaction to the anesthesia.
What happens after treatment for the condition?
After delivery, the woman will be watched closely for signs of continued bleeding. This entails monitoring frequent CBCs, evaluating clotting times, and watching vital signs. The surviving infant will likewise be observed in the intensive care unit.
How is the condition monitored?
If a woman is pregnant and develops any of the signs of this condition, she should call her doctor right away.
Author:Eva Martin, MD
Editor:Crist, Gayle P., MS, BA
Reviewer:Kathleen A. MacNaughton, RN, BSN