The placenta forms during pregnancy to give nutrients and oxygen to the baby and remove waste products. Normally, the placenta attaches to the wall of the uterus until the baby is born, but sometimes, the placenta separates from the uterus before birth. This is called placental abruption, or placenta abruptio. Below, we offer some details around potential causes and what to expect during treatment for this condition.
Symptoms
Potential warning signs for a placental abruption include:
- Light, moderate or severe vaginal bleeding
- Mild to severe pain in your belly
- Signs of early labor
- Less fetal movement
- Symptoms of shock:
- Cold, clammy skin
- Rapid or weak pulse
- Rapid, shallow breathing
- Low blood pressure
- Dizziness or lightheadedness
- Confusion or disorientation
- Anxiety
Prevention
There is no sure way to prevent placental abruption, but you can do things to lower your risk. Your risk is much higher than normal if you have had placental abruption before, so these steps are particularly important if you’ve had a prior diagnosis.
- If you have high blood pressure, follow your doctor's treatment advice.
- Don't smoke while you're pregnant.
- Don't use drugs, like cocaine and methamphetamine.
- Get regular prenatal checkups throughout your pregnancy.
- Wear your seat belt properly while riding in a car. A car accident can cause placental abruption, and proper use of your seat belt can decrease the risk. Buckle the lap belt below your belly and across your hips. And place the shoulder belt across your chest, between the breasts, and away from your neck.
- Avoid contact sports and other activities that increase your risk of injury, such as basketball, soccer, skiing and motorcycle riding.
Causes
Doctors aren't sure what causes a placental abruption, but some factors can raise your risk. Common risk factors for placental abruption include:
- High blood pressure, whether the high blood pressure is a long-term problem or is caused by the pregnancy.
- Having had placental abruption before.
- Smoking during pregnancy.
Less common risk factors include:
- Using cocaine.
- Having a scar from a past surgery or a uterine fibroid where the placenta is attached to the wall of the uterus.
- Having an injury to the uterus. This could occur because of a car accident, a fall, or physical abuse.
- Pre-labor rupture of membranes for 24 hours or more, especially when there is an infection in the uterus.
Diagnosis
This problem can be hard to diagnose. Your doctor will ask questions about your symptoms and do a physical exam. Tests that may be done include:
- Electronic fetal monitoring. This is to assess your baby's condition and check for contractions of the uterus.
- An ultrasound. This test can detect about half of placental abruptions.
- A CT scan. This may be done if you had an injury to your belly.
If placental abruption is suspected, you'll probably need to be in the hospital until your doctor is able to evaluate the severity of your condition.
Treatment
The kind of treatment you need will depend on:
- The severity of the abruption.
- How it is affecting your baby.
- Proximity to your due date.
If you have a mild placental abruption and your baby is not in distress, you may not have to stay in the hospital.
- You and your baby will be checked often throughout the rest of your pregnancy.
- If you are in preterm labor and are far from your due date, you may be given medicine to stop labor. You may also be given medicine to help the baby's lungs mature faster.
If you have moderate to severe placental abruption, you will probably have to stay in the hospital so your baby's health can be watched closely.
- In most cases, the baby will need to be delivered quickly. This means you are likely to have a C-section (cesarean delivery).
- If you have lost a lot of blood, you may need a blood transfusion.
If your baby is premature, the baby may be treated in a neonatal intensive care unit, or NICU. The NICU is geared to the needs of premature or ill newborns.
Your doctor will watch your condition closely to make sure you and your baby are safe. A minor abruption can sometimes be watched closely until delivery. But any bleeding or pain during pregnancy is cause for concern. Call your doctor if you experience any of these symptoms.
To learn more about OB/GYN care at Parkview, visit us here.
Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.
