Placenta is a fleshy organ which develops during pregnancy to nourish the growing foetus. The placenta attaches itself to the wall of the uterus and the all oxygen and nutrients to the baby is transferred through the placenta. The placenta usually separates immediately after delivery and is expelled. However in some situations the placenta may peel away from the wall of the uterus before the baby is delivered. This condition is known as Abruption of placenta. Abruption of placenta is a rare but serious complication of pregnancy. It is an emergency and needs emergent medical and surgical management. The symptoms of abruption are:
Abruption causes bleeding mostly after 20 weeks of gestation. The bleeding may be frank or consist of altered blood. It is not possible to estimate the degree of abruption from the amount of vaginal bleeding. It is possible for severe abruption to present with little or no bleeding. Both abdominal pain and back pain start suddenly and are quite severe and may be cramping. The pain may radiate to the thighs as well. If you experience any of the above symptoms you must contact your doctor immediately. The causes of placental abruption are not clear but a few of the following conditions are known to be associated with a higher incidence of abruption:
But in majority of the cases of abruption no specific cause is found. Since abruption presents suddenly it leaves no time to prepare either mentally or physically. Women may be having plenty of questions and may be under a lot of stress and strain. The following may help: Have your spouse or a relative or friend with you when you visit the emergency or the doctor. They will be of support to you. Think of all the details you can recollect about the problem. Inform the doctor in detail about all symptoms you are suffering from. Also inform your doctor about any substance abuse (especially cocaine) and smoking. In the emergency or the doctor’s office you are likely to be asked further questions about the pain and bleeding. Once these questions are done with you can expect your B.P to be measured and a general physical exam carried out. The doctor will then gently examine your abdomen and listen to your baby’s heart beat. Following this he may order a few blood tests and an ultrasound. The USG is probably the most important and competent investigation to diagnose placental abruption. USG will be able to quantify the degree of placental compromise and bleeding. It will also help assess foetal maturity and health. Once a diagnosis of abruption is made the further course of management depends on two factors:
There is no way to re attach a placenta which is separated; hence most of the care is supportive. If the baby is not sufficiently mature and the bleeding has stopped then the woman may be advised absolute bed rest and both the mother and baby monitored carefully. In some cases steroids are given to the mother to enhance the maturity of the baby’s lungs. If the baby is near term then the baby is usually delivered either vaginally if conditions are favourable or by a caesarean section if there is an emergent need to terminate the pregnancy. Placental abruption may lead to the following complications:
Since placental abruption occurs suddenly without any fore warning there not much prevention available, but the following measure will help reduce the complications due to abruption and improve the outcome:
Although placental abruption is a serious disorder of pregnancy most women go on to deliver healthy kid in the present as well as future pregnancies.