©Pregnancy bliss 2008
Placental abruption
Placental abruption is the separation or detachment of the placenta from its implantation site during pregnancy. The placenta is supposed to remain attached to its base until the baby has been delivered. If detachment occurs any time before, that is placental abruption or "abruptio placenta", as the condition is classically known.
Placental abruption is a serious pregnancy complication. Of course, the outcome depends on when it occurs during the pregnancy and the extent of the detachment.
Symptoms of placental abruption
The classic presentation of placental abruption is abdominal pain and vaginal bleeding.
However, abruption can occur with no revealed bleeding at all and only with abdominal pain which varies in intensity. In some cases it is disguised as painful labor onset.
Significance of placental abruption
When the bleeding is heavy - which is not uncommon in this condition - the pregnant
woman may go into shock quite quickly.
The bleeding can also cause other complications. Even after delivery, bleeding could continue and may remain a difficult problem to contain.
Obstetric hemorrhage, placental abruption being one of the chief causes, continues to take a heavy toll on lives of mothers across the globe, even in developed countries. In the three years between 1997 and 1999 seven women in England and Wales died because of hemorrhage and 3 of these were due to placental abruption.
The baby fares badly, too. Figures published in various developed countries show that anything between 14 and 65 per cent of these babies are lost as a direct consequence. Half of these are stillborn, the remainder dying shortly after birth.
A study based on over 7 million babies born in the United States in the years 1995 and 1996 showed a perinatal mortality of 119 per 1000 births in the group with abrution. This was almost 14 times higher the general average (8.2 per 1000).
Perinatal consequences of placental abruption
Babies in pregnancies affected by this condition tend to be growth-restricted. In
fact, four out of five (80%) such babies will have some degree of growth restriction
at birth.
The birth itself is also usually premature. In fact, over 50% of babies lost following placental abruption, prematurity is the cause.
These babies are also more prone to have major malformations, almost twice the average expected rate.
By the nature of the condition, even a baby born alive may have quite severe anemia, requiring emergency transfusion immediately after birth.
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Fetus
Endometrium
Placenta
Umbilical cord
Hemorrhage
Cervix