Placental Abruption : Placental Pregnancy Complication

 

The placenta is a very important part of your pregnancy. It keeps your baby safe from bacteria, carries food and oxygen from you to the baby, eliminates the baby’s waste, and separates your baby’s blood from yours. The placenta is also the main organ for hormone production during pregnancy. It works around the clock throughout your pregnancy and keeps things going smoothly.

Any pregnancy complications to your placenta can seriously hamper your baby’s health and yours as well. This is why it is crucial that you educate yourself about the different placental pregnancy complications so you can reduce your risk of developing them, and in the unfortunate event that you do suffer from them you know what symptoms to look out for so you can call for medical attention. Placental abruption is one of those pregnancy complications which you must know about, even though it is quite rare.

In a normal pregnancy, the placenta is attached strongly high up on the uterine wall. Any deviation in the location or condition of the placenta can cause several pregnancy complications, some common, others fatal. Placental abruption falls into the latter category. Let’s take a look at what placental abruption is, what causes it, and what the symptoms are.

 

What Is Placental Abruption?

Placental Abruption Placental Pregnancy Complication

One of the rare placental pregnancy complications is placental abruption, medically known as abruptio placentae. If you have placental abruption during pregnancy, your placenta will either partially or fully break away from the uterine wall before delivery. 

Most cases of placental abruption occur in the pregnancy third trimester. Be warned, however, that if you are at high risk for placental abruption it can happen any time after your 20th pregnancy week. One out of every hundred women will suffer from placental abruption.

Complications of Placental Abruption

Placental abruption is one of those pregnancy complications that is actually an emergency situation because it puts both the baby’s and the mother’s life at risk.

How placental abruption affects the mother:

If the placenta breaks away from the uterus, it can cause massive internal bleeding, which can lead to shock and eventually death if the mother is not treated immediately. Even if the mother is receiving medical attention, a few cases of placental abruption lead to difficulties in stemming the bleeding from the site of the placental abruption. The only way to resolve the bleeding may be to immediately remove the uterus entirely (hysterectomy) which means the woman cannot have any more children in the future.

How placental abruption affects the baby:

Placental abruption can deprive the baby of nutrition and oxygen, which can lead to several complications like low birth weight, birth defects, brain damage, internal bleeding, organ failure, and death. Placental abruption can also cause premature birth, which can further lead to several problems for your baby like developmental delays, neurological issues, and  breathing problems.

Causes of Placental Abruption

As with the reasons for most pregnancy complications, doctors just do not know why placental abruption happens. While they are aware that it has something to do with placental problems – the placenta is not formed properly or is not placed in the right position in the uterus – they do not understand why it should be so. However, a few direct causes of placental abruption have been identified.

  • Physical trauma to the abdomen during pregnancy can cause the placenta to come loose from the uterine wall, thus leading to placental abruption and the pregnancy complications that follow.
  • If you suddenly lose volume from the uterus – as would be the case if your amniotic sac burst or when you have delivered the first of your twins – it can cause placental abruption.
  • For reasons unknown, having a shorter than normal umbilical chord causes placental abruption.

Risk Factors of Placental Abruption

While the causes of pregnancy complications like placental abruption are unclear in most cases, long-term observation has allowed researchers and doctors to identify the risk factors associated with placental abruption in particular.

Smoking: Doctors have long warned of the dangers of smoking during pregnancy. Not only does smoking – even if it is just one cigarette a day – increase your risk of placental abruption, it is a known risk factor for hundreds of other pregnancy complications. And second-hand smoke is just as bad. So do yourself and your baby a favor and kick the filthy habit.

Drug abuse: Not recommended even for the healthiest folks, drugs are a strict no-no during pregnancy precisely because they increase your chances of placental abruption and other pregnancy complications. Cocaine users especially seem to be more likely to have placental abruption.

High blood pressure: Hypertension or high blood pressure during pregnancy can be fatal in some cases. In all cases, it causes pregnancy complications of some kind, placental abruption being just one of them.

Uterine scars: Sometimes, the placenta can grow from a scar from the site of a past surgery on your uterus, which significantly increases your risk of placental abruption. Researchers feel that this may be because the scar tissue is not stable enough for a placenta to firmly attach itself.

Amniocentesis: In rare cases, amniocentesis – a regular prenatal test – may cause placental abruption.

Polyhydramnios: This is a condition in which there is too much amniotic fluid in the womb, and is a risk factor for placental abruption.

Diabetes: Diabetic pregnant women seem to be a a higher risk for placental disruption.

Premature rupture of amniotic membranes: The outer covering of the amniotic sac is called the amniotic membrane. When you are going into labor, the membrane breaks – what is commonly known as water breaking. Sometimes, the membrane can tear or develop a hole  before you have come to full term. This can increase your chances of placental abruption and several other pregnancy complications for both you and your baby. For example, it can cause premature birth. If you have a uterine infection, the bacteria can now easily infect your baby.

Multiple pregnancies: The number of times you have been pregnant is directly proportional to your risk of having placental abruption.

Multiple foetuses: Are you carrying more than one baby? Women who are pregnant with twins, triplets or anything more than one baby are more likely to have placental abruption.

Age: The mother’s age is usually a risk factor for pregnancy complications. The older you are, the higher your risk of having placental abruption. Women above the age of 35 are especially at risk.

Underweight mother: You should be gaining weight normally during your pregnancy to avoid pregnancy complications. If you were underweight before pregnancy and are having a hard time gaining weight while you are pregnant, you could be at an increased risk of placental abruption. If you go on a diet during pregnancy to lose weight, this again would put you at a higher risk for placental abruption.

Prior placental pregnancy complications: If you suffered from placental abruption in a previous pregnancy, you are at higher risk for it in your current pregnancy.

Disorders of the blood: A blood-clotting disorder in particular greatly increases your risk of placental abruption.

Prior C-section: Some studies indicate that having a baby via cesarean section in a past pregnancy may slightly increase your risk for placental abruption. This may be because a C-section will leave a scar on your uterus, and as we have seen that is a risk factor in itself.

Symptoms of Placental Abruption

Now that you know how risky it can be to have placental abruption, keep a sharp eye out for the following symptoms of the condition.

  • Vaginal bleeding is a symptom of placental abruption. However, you can have placental abruption and no bleeding at all. And the level of bleeding does not necessarily correspond to the severity of the placental abruption. There can a tiny break with a lot of bleeding and vice versa.
  • If you experience abdominal pain during pregnancy, it could be a sign that you have placental abruption.
  • If you have placental abruption, you may feel a tenderness in the uterus at the site where the placenta has come away. The uterus may feel hard or tight.
  • Sharp back pain is another indication that you may be suffering from placental abruption.
  • Some women experience uterine contractions when they have placental abruption. The contractions are usually quite rapid and come in waves that make the contractions seem almost continuous. Researchers feel that this may be the uterus’ attempts to eject the placenta from the uterus.
  • If the placenta has broken away, you may experience nausea and feel like fainting; you may also have difficulty breathing, feel lightheaded or weak, and experience confusion. These are all signs of shock from uterine blood retention so call emergency services right away.
  • Your baby’s heart rhythm may change if you have placental abruption since it is being starved of food and oxygen. This is one of the things your doctor will check for to diagnose placental abruption.    

As you can see, all these symptoms of placental abruption are quite generic and correspond to several other pregnancy complications as well. So although you should not presume the worst if you experience any of these symptoms, you should definitely see your doctor immediately.

Diagnosis and Treatment for Placental Abruption

Your doctor will do a blood test to check if you have anemia from loss of blood, and conduct an ultrasound to diagnose placental abruption. However, a placental abruption does not always show up on an ultrasound so your doctor will depend on results of the other tests and your description of your symptoms to diagnose placental abruption. She may give you a physical exam to check for tenderness in the uterus, and check your baby’s heartbeat to assess its condition. It is only after placental abruption has been diagnosed and its severity determined that any action can be taken.

Once a placenta has separated from the uterine wall, there is nothing you or your doctor can do to reverse it. But certain steps can be taken to prevent harm to you and your baby. The options open to you if you have placental abruption will depend on two things – how severe your case is and how close you are to full term. If your doctor suspects that you have placental abruption, you will be kept in the hospital for a few days at least.

  • If the bleeding is very heavy and you are close to your due date or above 37 weeks pregnant, your doctor will recommend a C-section. This is so that you do not go into shock and blood loss, and so that your baby has a better chance of surviving.
  • If the bleeding is heavy and you are not close to full term, your doctor will monitor you to see if the bleeding stops. If it does, you will remain hospitalized and be closely monitored while given medication to aid rapid development of your baby’s lungs. This way, if bleeding recurs, your baby will have to be delivered immediately and will at least be able to breathe when it is born.
  • If the bleeding ranges from minimal to mild, you will be advised bed rest or kept under hospital observation for awhile. As long as the baby’s condition as well as your own remains stable, you will have to be extra careful until your 37th pregnancy week, which is when your baby can be safely delivered.
  • In any of the above cases, very heavy bleeding is a possibility. If this happens, you may need a blood transfusion.
  • If the bleeding shows no signs of stopping, your doctor may have no choice but to remove your uterus to save your life.

 Prevention of Placental Abruption

There is no known remedy for preventing placental abruption from occurring. If it has to happen, it will. But as we have seen earlier from the risk factors of placental abruption, some of them are within your control. So by making sure that you do not fall under a certain risk category, you can reduce your chances of developing placental pregnancy complications like placental abruption.

  • Quit smoking even before you get pregnant. Research has shown that smoking causes several pregnancy complications which are just as severe as placental abruption. By quitting, you are increasing your odds of having a normal pregnancy and a healthy baby.
  • Put safety measures in place around the house and in your car that can help prevent or minimize injury in case of an accident. For example, put handrails in the bathroom and wear a seatbelt when you are driving.
  • If you are abusing any drugs – whether recreational or medicinal – stop immediately. Cocaine especially is seen to dramatically increase the risk of placental abruption in addition to hundreds of other pregnancy complications.
  • Experts suggest taking folic acid on a daily basis to reduce your chances of having placental abruption. The amount you can safely take will depend on your individual condition so let your doctor advise you.
  • If you are suffering from high blood pressure or any other ailments during pregnancy, see your doctor about bringing them under control. The longer you allow yourself to be sick, the greater your chances of developing placental pregnancy complications.
  • And lastly, stick to  your doctor’s appointments so that threatened placental abruption and other pregnancy complications can be caught as early as possible.

 

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