Researchers Emphasize Need to Identify
Mothers at Risk for Placental Abruption
Abruptio placentae, or placental abruption, is a condition in which the placenta tears away from the uterine wall and is a significant risk factor for stillbirth and premature delivery, according to researchers from the University of Medicine and Dentistry of New Jersey and the Robert Wood Johnson Medical School in New Brunswick, New Jersey.
Analyzing more than 53,000 pregnancies occurring at New York's Mount Sinai Hospital between 1986 and 1996, researchers found that approximately one percent, or 530 pregnancies, experienced abruptions. These 530 pregnancies resulted in a higher rate of stillbirth, preterm delivery, and low birth-weight babies.
For women experiencing placental abruption, five percent had stillbirths, 40 percent delivered two weeks early, and 35 percent had low birth-weight babies. In normal pregnancies, stillbirth occurs in less than one percent of the deliveries, nine percent involve early delivery, and six percent result in low birth-weight babies.
The researchers mention that known risk factors for placental abruption can be prevented thorough prenatal care and healthy maternal behavior. This would include the health-care provider consistently monitoring a woman's blood pressure during her pregnancy. On the woman's part, she needs to avoid cigarettes and drug use, including alcohol.
However, there are other known risk factors. Anatomical abnormality of the uterus, accident or trauma, short umbilical cord, overabundance of amniotic fluid, and maternal age are factors over which no one has control.
The surest sign of abruption is bleeding. However, sometimes the blood collects within a pocket, so the woman may not notice evidence of vaginal bleeding. Other symptoms include abdominal tenderness or pain in the area of the uterus; excessive contractions and early labor; and fetal distress, which would require fetal monitoring to detect.
The researchers urge clinicians to try and identify women at risk for placental abruption early in their pregnancies and to monitor them more closely. Pregnant women with risk factors or women experiencing any of the signs and symptoms listed above should contact their health-care provider right away.
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