Abruptio Placenta

What is abruptio placenta?

  • Abruptio placenta is a condition that can occur in your uterus (womb) before your baby is born. With abruptio placenta, all or part of your placenta pulls away from the wall of your uterus. The placenta forms during pregnancy and brings oxygen and nutrition from the mother to the fetus (unborn baby). The placenta also removes waste products from the fetus. Normally, your placenta stays attached to the wall of your uterus until your baby is born.

  • When your placenta pulls away during pregnancy, you may have vaginal bleeding or bleeding inside your uterus. Abruption of your placenta can be painful and may be life-threatening for both you and your baby. Treatment may help to resolve your bleeding and pain. Treatment may decrease your risk for having your baby earlier than he is ready to be born. Treatment may also save yours and your baby's life.

What causes abruptio placenta?

The exact cause of abruptio placenta is not clear. Caregivers believe damage to the placenta's blood vessels may cause bleeding and blood clots to form. The blood clots may then push the placenta away from the wall of your uterus. Caregivers also believe there may be an inflammatory (swelling) condition that causes the placenta to pull away.

What increases my risk for abruptio placenta?

Your risk for abruptio placenta increases as you get older. Past pregnancies that resulted in an abortion or miscarriage may also lead to abruptio placenta. The following may also increase your risk:

  • Alcohol, smoking, and street drug use: Drinking alcohol and smoking during pregnancy increases your risk of placental abruption. Examples of alcohol are beer, wine, whiskey, and vodka. The more cigarettes you smoke, the greater your risk. Your risk also increases if your partner smokes around you. Use of street drugs such as cocaine also may lead to abruption of your placenta.

  • Bleeding: Bleeding during the first trimester (before the 12th week) of your pregnancy may increase your risk for abruption. You risk increases more if you have bleeding during both your first and second trimester (weeks 12 to 28).

  • Medical conditions: The following medical conditions may increase your risk for abruptio placenta:

    • Abnormally shaped uterus

    • Asthma or a lung infection

    • Blood clotting disorders

    • High blood pressure

    • Infection in your uterus or placenta

    • Lack of nutrition and vitamins

    • Too much or too little fluid in your uterus

  • Pregnancy: The more times you have been pregnant, the higher your risk is for the condition. Your risk also increases if you had abruptio placenta during a past pregnancy. Being pregnant with more than one baby such as twins, also increases your risk. Early rupture (break) of the fluid filled sac that holds your unborn baby may also lead to abruptio placenta.

  • Past C-section: A C-section is surgery to deliver your baby through a cut in your lower abdomen (stomach) and uterus. A past C-section may cause changes in your uterine tissue. The tissue changes may increase your risk for an abruption.

  • Trauma: Motor vehicle accidents are a common trauma that may lead to abruptio placenta. You are also at risk if you are injured or attacked by another person while pregnant.

What are the signs and symptoms of abruptio placenta?

You may have no signs and symptoms when you have abruptio placenta. When your placenta pulls away from the uterine wall you may have bleeding that becomes trapped inside. Trapped blood may cause the fluid filled sac holding your unborn baby to weaken and break open. You may have any of the following signs and symptoms:

  • Bleeding from your vagina that may be very light to very heavy.

  • Abdominal pain or tenderness.

  • Back pain.

  • Contractions (cramping of your uterus).

  • Dizziness and feeling like you are going to faint (pass out).

  • Feeling like your heart is beating much faster than what is normal for you.

How is abruptio placenta diagnosed?

Your caregiver will ask you about your signs and symptoms. Tell your caregiver about any previous pregnancies and problems you may have had. If you have vaginal bleeding, your caregiver may do an exam to check where the bleeding is coming from. Your caregiver may also put a fetal monitor on your stomach to check your unborn baby's heartbeat. You may also need the following:

  • Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.

  • Ultrasound: An ultrasound uses sound waves to show pictures of your uterus on a TV-like screen. The pictures help show the amount of fluid inside your uterus. The ultrasound can show the location of your placenta and if you have any blood clots. Your baby's position inside your uterus may also be seen. You may need to have more than one ultrasound when you have abruptio placenta.

How is abruptio placenta treated?

Treatment will depend on how far along you are in your pregnancy. You may need any of the following:

  • Bed rest: You may need to be on bed rest until your baby is ready to be born. You may be able to rest at home or you may need to stay in the hospital. If you are in the hospital, your caregiver may keep you on a monitor. A monitor is used to watch your vital signs (heart rate, breathing, and blood pressure). You may also need to wear a fetal monitor. Talk to your caregiver about what activities are OK while you are on bed rest.

  • Medicine:

    • Tocolytics: Tocolytics are given to stop contractions if your baby is not ready to be born. Contractions are when the muscles of your uterus tighten and loosen.

    • Steroids: Steroid medicine may be given if you need to deliver your baby earlier than expected. Steroids help your baby's lungs to function and prevent breathing problems after he is born.

  • Delivery of your baby: Early delivery of your baby may be needed when you have abruptio placenta. If your due date is close, and you have a partial abruption, you may be able to give birth vaginally. If your abruption is severe or complete, a C-section is commonly done. A C-section may also be done if you have heavy bleeding, or you or your baby is in danger.

  • Blood transfusion: You may need a blood transfusion if you lose a large amount of blood. During a blood transfusion, donated blood is given to you through an IV. An IV is a tube that is put into your vein for given medicines or fluids such as blood.

What are the risks to my health with abruptio placenta?

Risks to your health may depend on how severe your abruption is. Do not ignore any signs and symptoms you have, as they could mean you are in danger. Having abruptio placenta may increase your risk for blood clotting and bleeding problems. You may have vaginal bleeding that cannot be stopped or controlled. Your kidneys may fail, and your heart may not work as it should. Abruptio placenta can be a very serious condition, and you may die. Having abruptio placenta may make you feel worried and scared. Talk to your caregiver, family, and friends about your feelings. Ask your caregiver if you have questions or concerns about your condition, treatment, or care.

What are the risks to my unborn baby with abruptio placenta?

If you have abruptio placenta, your unborn baby may not get the oxygen and nutrition it needs to grow and survive. Your unborn baby may have problems with his heart rate. Your baby may be born too early, and his lungs may not function properly. If your baby is born too early, he may be very small, and he may die. Your baby may also be at an increased risk for Sudden Infant Death Syndrome (SIDS). Talk to your caregiver about any concerns you have about your unborn baby's health.

When should I call my caregiver?

Call your caregiver if:

  • You are having contractions.

  • You have blood spotting from your vagina.

  • You have a fever (high body temperature).

  • Your heart is beating faster than what is normal for you.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • Your unborn baby is moving less than usual, or not at all.

  • You have a large amount of vaginal bleeding.

  • You are leaking fluid from your vagina, or a large amount of fluid comes out of your vagina.

  • You are having severe abdominal pain or contractions.

  • You have new and sudden chest pain or trouble breathing.

  • You are urinating less than what is normal for you, or not at all.

  • You fainted or feel too weak to stand up.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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