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Pregnancy Complications

Placenta Problems ~ Abruptio, Previa, etc.

Placenta Abruptio

What is placenta abruptio?

Placenta abruptio (or placental abruption or abruptio placentae) is the premature separation of the placenta from the uterine wall. This can cause a disruption in the flow of oxygen to the baby and serious bleeding in the mother. The separation may be partial or it may be complete where the entire placenta is separated from the uterus.

Placenta abruptio occurs in approximately 1 out of 150 births. The recurrence rate for women who have had a previous placenta abruptio is 5% to 17% after the first episode of abruption, and a 25% rate is seen after the second episode.1

What are the causes of placenta abruptio?

Often the cause of placenta abruptio is unknown although there are some risk factors:

  1. past history of placenta abruptio
  2. hypertension (the most common risk factor)
  3. several previous pregnancies
  4. advanced maternal age
  5. poor nutrition
  6. smoking
  7. cocaine use
  8. African American descent
  9. abdominal trauma such as a car accident, fall or direct blow to the abdomen
  10. short umbilical cord

What are the symptoms of placenta abruptio?

Although placenta abruptio always involves bleeding, it's not always apparent so any spotting or bleeding should be reported to a careprovider. Symptoms may include bleeding (scant, heavy or in between), back or abdominal pain, uterine tenderness and contractions.

What are the risks of placenta abruptio?

Mild abruptions may irritate the uterus and cause preterm labor. Complete abruptions can be life threatening for both mom and baby. Hemorrhaging can cause serious complications for mom. The baby may experience serious oxygen deprivation and/or preterm birth with associated complications.

What is the treament for placenta abruptio?

If the abruption is mild, the pregnancy may continue with close monitoring. Bedrest is usually prescribed in the hospital, or possibly at home if the abruption is very mild.

If other complications precipitated the abruption (such as hypertension or preeclampsia), they will need to be treated and monitored along with the abruption.

If the placenta continues to separate from the uterus, if bleeding becomes heavy, or if either mom or baby becomes unstable, then an immediate c-section is probably necessary.

1. Heppard, Martha C.S. and Thomas J. Garite. Acute Obstetrics (Missouri: Mosby-Year Book, Inc, 1996), pp 200.

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