Placental Abruption
Detachment of the Placenta from the Uterus
Pregnancy brings with it the possibility of complications. The placenta is evaluated during the pregnancy for position and any abnormalities that may be present. Placental abruption, also known as abruptio placenta, is an uncommon complication that may occur. It is the tearing of the placenta away from the uterine wall and can occur after the twentieth week of pregnancy.
Risks
Trauma to the abdomen, as with a car accident, is an obvious situation that warrants an ultrasound for the assessment of a possible abruption. Other causes of placental abruption are not always known, but there are many risk factors associated with it.
Pregnancy history is related to one's risk of placental abruption. The risk increases with each successive pregnancy. The risk increases by more than 15% for those who have had a placental abruption with previous pregnancies. Twin and other multiple pregnancies are also at an increased risk. The presence of a subchorionic hemorrhage may also lead to an abruption.
Maternal health also influences the risk of placental abruption. Preexisting hypertension and pregnancy-induced hypertension contribute to an increased risk. Various disorders affecting blood clotting can also contribute to placental abruption. Age is also a risk factor. Placental abruption is more prevalent in women who use recreational drugs, such as alcohol and tobacco.
Signs and Symptoms
Identifying the signs and symptoms of placental abruption can be critical to the health of the mother and fetus. While bleeding is not directly related to the size of the abruption, it can be minimal or profuse. Sudden pain in the abdomen and back are likely, as well as shortly-spaced uterine contractions accompanied by tenderness.
Diagnosis and Treatment
Emergency care should be sought out should any of these signs and symptoms occur. Mild placental abruption may warrant hospitalization and monitoring while medication is given to promote fetal lung maturation in preparation for early delivery. Biophysical profiles may be done to assess fetal well-being. In more serious cases, delayed care can lead to shock resulting from excessive blood loss. Maternal and fetal death may also occur. If bleeding cannot be controlled after delivery, hysterectomy is likely. Hysterectomy is the removal of the uterus.
The physician will complete a physical examination to aid in the diagnosis of placental abruption. Blood tests may be used to help confirm the diagnosis. Ultrasound is used to confirm the presence of placental abruption, although it may not always be seen. If placental abruption and fetal distress are suspected, the obstetrician may opt for early delivery and inspection of the placenta. The presence of a blood clot with the placenta may confirm placental abruption.
Mayo Clinic: Placental abruption
Ultrasound is Used to Diagnosed an Abruption
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