Placental abruption is a rare complication of pregnancy affecting less than 1% of all pregnant women. When it occurs, however, the results can be life-threatening. Not only is the mother at risk for health issues, but infants are at risk for death or conditions and disorders that can last a lifetime.
Placental Abruption Defined
Placental abruption is defined as the separation of the placenta from the inner wall of the uterus, usually after the 20th week of pregnancy. The placenta is the primary way in which infants receive nutrients and oxygen. If the placenta erupts, or pulls away from the uterine wall, before the baby is born, not only is the baby at risk, but the mother may have extremely heavy bleeding. Unfortunately, abruption happens quickly and in many cases without warning.
Placental Abruption Symptoms
One of the first and most common symptoms of placental abruption is severe abdominal pain and back pain, which typically happens suddenly, seemingly out of nowhere. Bleeding usually follows, and the amount will vary depending upon the person. While some women will bleed heavily, others may experience light bleeding or no visible bleeding at all.
Other symptoms may include:
- Tender uterus
- Extremely rapid uterine contractions
- Abnormalities in fetal heart rate
Placental Abruption Causes and Risk Factors
Unfortunately, the cause of placental abruption is still unknown, although experts are continuously researching the condition. Scientists and other experts suggest it may happen due to abdominal trauma or loss of amniotic fluid.
A number of risk factors may contribute to the risk of placental abruption, including:
- Advanced maternal age (40 and older)
- Previous cases of abruption
- Membrane ruptures
- Blood clot disorders
- Carrying twins, triplets (more than one baby)
- Smoking and/or using illegal drugs
- High blood pressure
Consequences of Placental Abruption to Infants
Physicians and medical staff must react quickly when placental abruption occurs. If not, the consequences can be devastating to infants, including:
- Preterm birth
- Stillborn birth
- Growth issues
Placental Abruption and Cerebral Palsy
Cerebral Palsy (CP) can develop for various reasons, including complications of the placenta. Since infants lose oxygen when placental abruption occurs, the lack of oxygen may lead to brain damage, which in turn may lead to CP. The risk of an infant developing CP will depend upon the length of time they go without oxygen, how much of the placenta separated from the uterine wall, how long the infant is in utero before delivery, and the infant’s gestational age when placental abruption occurs.
Placental Abruption Treatment
As mentioned earlier, there is no way to stop placental abruption once it has started, but there are a few treatment options available that may help the mother and infant.
If abruption is detected, physicians must start treatment immediately as there is only a small amount of time before devastating consequences occur. To begin with, an electronic fetal monitoring system is usually hooked up to the mother in order to monitor for infant oxygen deprivation and loss of blood flow. Other methods of testing for placental abruption may include blood tests, ultrasounds, and assessing the amount of bleeding and pain the mother has.
If abruption is assumed, treatment may consist of the following:
If the placenta has completely separated, the best course of action is usually to deliver the infant before the lack of oxygen and blood flow create long-term health issues and disorders. In addition, the infant may be at risk for death. In some cases, a normal delivery is possible if the infant is stable enough and old enough to sustain it. In most cases, however, a scheduled C-section may be necessary.
If testing indicates that the placenta has only partially abrupted and the infant is not in distress, bed rest is typically recommended. Doctors will closely monitor the situation and in some instances, may perform emergency treatments, such as a transfusion, to ensure the safety of both mom and baby.
Placental Abruption Prognosis
For mothers, although death rarely happens, they may face a host of health issues following placental abruption, including a closed cervix, excessive blood shock (if not treated, it may lead to shock), and concealed uterine bleeding. In extreme cases, a hysterectomy may be needed.
Infants, however, face a much more dangerous situation. Again, it’s extremely important for doctors to assess and treat placental abruption as soon as possible. According to the American Pregnancy Association (APA), if severe abruption occurs, 15% ends in fetal death. Infants who survive have a 40-50% chance of developing long-term health complications.
Placental Abruption Prevention Tips
Even though the cause of placental abruption is unknown, there are several prevention tips that all pregnant women should utilize, including:
- Refrain from any form of alcohol
- Don’t smoke cigarettes or partake in any recreational drug use
- If you’re diabetic, monitor your blood sugar closely and try to keep it under control as much as possible
- Keep all prenatal appointments and get regular checkups
- Keep on eye on your blood pressure levels