One pregnancy complication that sends every pregnant woman into panic is ‘bleeding’. Bleeding may or may not be a serious complication. The degree of complication is determined by the reason of bleeding, the quantity of bleeding, and during which month of the pregnancy does the bleeding occur. In this article, we are discussing an uncommon but a serious complication that arises during pregnancy – placental abruption.
Placental abruption

What Is Placental Abruption?

As we all know the placenta is a temporary organ that develops in the uterus during pregnancy. In normal case, it is found on the upper part of the uterus. Placenta joins mother and fetus. Oxygen and nourishment are transferred from the mother to fetus through the placenta. Normally, it will get peeled off from the uterine wall after the delivery. Placental abruption is the condition in which placenta get detached from the inner wall of the uterus either partially or completely too early before the time of delivery.
Placental abruption is a very serious condition because it will cutoff the oxygen supply and nourishment for your baby and also results in heavy bleeding thus putting both you and your child’s life in jeopardy.
Placental abruption is found to occur one in every hundred pregnancies. But the placental abruption putting the life of mother and child occurs only once in every 1500 delivery.

What Are The Reasons And Risk Factors That Lead To Placental Abruption?

Exact reasons for placental abruption is not found out yet. There are some factors which increase your risk of having placental abruption like:

  • When you are pregnant with multiples: Multiple pregnancy will increases the uterine distention (bulge due to internal pressure) which in turn can trigger placental abruption. Another chance is that when the first baby is delivered the uterine wall undergo some changes and placental abruption occurs before the delivery of other babies, putting their life on stake
  • Previous history of placental abruption: The chances of placental abruption increases if you experienced it in your previous pregnancy
  • Your age: If you are an older mother, crossed 35 years or more, the risk of placental abruption increases with your age.
  • Abdominal trauma: If your abdominal area is injured badly from a motor accident or from a fall or in case you get a blow to your tummy, the risk of placental abruption increases
  • High blood pressure: This is an important factor as more than half of the reported placental abruptions, the mother is found to have high blood pressure
  • Premature rupture of amniotic sac: Increased quantity of amniotic fluid or multiple pregnancies may result in rupture of the membrane before delivery. Rupturing of amniotic sac is one of the reasons for placental abruption
  • Other pregnancy complications: If you are having other pregnancy complications such as sub chorionic hematoma, umbilical cord problems, uterine fibroid, uterine infections, etc.
  • Blood clotting disorder: As the ability of your blood to clot decreases the risk of placental abruption increases. On the other hand thrombophilia (abnormally increased tendency of the blood to clot) is also found to increase the chances of placental abruption
  • Unhealthy practices: Placental abruption is more common among women who smokes, use narcotic drugs, drinks alcohol, during pregnancy
What Are The Complications That Arise Due To Placental Abruption?

Placental
effect on mother includes:

  • Hypovolemic shock: This is a condition develops after heavy loss of blood. It is a state of decreased volume of blood plasma. If not enough blood is transfused this is a life threatening condition
  • Kidney failure or permanent organ damage is also an outcome of Hypovolemic shock
  • Hemorrhage during labor
  • Placental abruption’s effect on baby includes
  • Pre mature birth, still birth or birth with abnormalities due to the deprivation of oxygen and nutrients
What Are The Warning Signals Of Placental Abruption?

Mostly reported placental abruption are found to occur during last trimester of pregnancy. The symptoms of placental abruption are:

  • Vaginal bleeding or spotting, though calculating the severity of abruption is not possible regarding the bleeding because there is no relation between the amount of bleeding and severity of abruption. It is even possible that severe placental abruption and no bleeding at all as the blood gets trapped inside the uterine wall
  • Abdominal pain and back pain that begins suddenly
  • Decreased fetal movement
  • Rapid uterine contraction: Uterine contraction will be frequent almost one after another. Sometimes there will be no relaxation between the contractions
How Is Placental Abruption Diagnosed?

Placental abruption can be graded into three as follows:

  1. Grade 1: Amount of vaginal bleeding is less. No significant uterine contraction. No blood pressure variation. Normal fetal heart rate. In this case, placental abruption is only diagnosed after delivery when clotted blood is found behind the placenta
  2. Grade 2: Moderate amount of bleeding. Significant uterine contraction. Low blood pressure. Fetal heart rate shows signs of distress
  3. Grade 3: Severe bleeding or concealed bleeding. Increased uterine contraction without relaxations and severe abdominal pain. Blood pressure decreases dangerously. Possible fetal death

Diagnosing of placental abruption mainly depends upon how severe your symptoms and abruption are. Your doctor rely on following symptoms to diagnose placental abruption even if the bleeding is concealed.When placental abruption is suspected your doctor will go for an ultra sound. The heart rate of your baby will be monitored. Declining heart rate indicates placental abruption. Your blood pressure will be monitored. Your blood pressure tends to decline when you undergoes placental abruption due to the loss of blood.

How Can Placental Abruption Be Treated?

Once separated, reattachment of the placenta is impossible. When a mother is diagnosed with placental abruption the treatment options rely on the circumstances such as:

  • The grade of abruption – Grade 1 (mild), Grade 2(moderate) or Grade 3(severe)
  • The term of pregnancy
Placental Abruption When The Baby Is Not Close To Full Term

If mother and baby are fine and the abruption is mild the doctor suggests hospitalization for close monitoring. After he is convinced that the bleeding is stopped and the baby is stable he may send the mother home and advice for strict bed rest for the rest of the pregnancy. If the bleeding doesn’t stop he will hospitalize the mother and closely monitor the health variation of mother and child. He will prescribe medicines to speed up the child’s lung development foreseeing a preterm birth. He won’t suggest on induced delivery at this circumstances because the baby will grow inside the womb more safely.

Placental Abruption When The Baby Is Close To Full Term

When the baby is close to full term the doctor suggests for an early delivery when the mother is diagnosed with placental abruption as the child attained the adequate development and an early delivery reduces the risks further complication. The doctor may go for a closely monitored vaginal delivery by inducing pain if the rupture is mild. He will go for an immediate C-section if the abruption progresses significantly and the bleeding changes to moderate or severe. At this grade of placental abruption, immediate delivery is the only option to minimize the complications.
Your doctor will weigh up the risk of worsening abruption against the risk of premature birth. Trust your doctor and go according to his plan.

Complications can arise at any point during pregnancy. You should be aware of the warning signals of various possible complications. This will help you to seek medical attention at the right time. For almost all possible complications that may arise during pregnancy, remedies are also there if diagnosed in the right time. Even a little discomfort during pregnancy can be the beginning of a life-threatening complication. Rather than worrying and being afraid about all the usual discomforts that arise during pregnancy, you should watch out if the uneasiness is progressing. Progressing discomfort always should be brought into the notice of your doctor.