Placental Abruption

Causes and risk factors

Mother’s age below 20 or above 35, multiparity, multiple pregnancy, history of abruptio placentae in previous pregnancies, history of previous caesarean section, hypertension, thrombophilia, smoking, maternal trauma, pre-eclampsia, short umbilical cord, some infections, cocaine abuse are some of the pre disposing factors for placental abruption.

Clinical presentation

Placental abruption can be partial or complete separation of placenta depending on which symptoms appear. Continuous uterine contractions, pain and tenderness in abdomen, vaginal bleeding, pallor, enlargement in size of uterus disproportionate with the days of pregnancy are signs and symptoms seen in placental abruption. If not treated on time it can lead to abortion or premature delivery or foetal complications.

Investigation

Medical history by the patient and Clinical examination by the gynaecologist help in diagnosis. An ultrasound examination may reveal placental abruption. Routine blood test might be done to rule out any infections.

Treatment

The treatment depends on amount of bleeding and status of the foetus in the womb. Induction of labour if it is full term is advisable. Vaginal delivery is preferred instead of C section. Blood transfusion required in case of heavy blood loss. If the baby is not close to full term, the patient is hospitalised and kept under observation till bleeding stops. Rest is recommended.

Facts and figures

Abruptio placentae occur in about 1 % of pregnancies all over the world.