Abruptio placenta, or placental abruption, is a serious pregnancy complication that occurs when the placenta separates from the inner wall of the uterus before delivery. This condition can disrupt the supply of oxygen and nutrients to the baby and may lead to dangerous bleeding for the mother. While it is relatively rare, understanding its causes, symptoms, and management can help ensure timely medical intervention and better outcomes for both mother and child.

What Causes Placental Abruption?

The exact cause of placental abruption is often unclear, but several risk factors have been identified:

• Abdominal trauma: Accidents, falls, or injuries to the abdomen can increase the risk.
• Rapid loss of amniotic fluid: Sudden changes in amniotic fluid levels may contribute.
• Hypertension: High blood pressure during pregnancy is a significant risk factor.
• Smoking and substance use: These behaviours can compromise placental health.
• Previous history: Women who have experienced placental abruption in a prior pregnancy are at higher risk.
• Multiple pregnancies: Carrying more than one baby increases the likelihood.
• Infections: Certain infections during pregnancy may also play a role.

Recognizing the Symptoms

Placental abruption can present with a range of symptoms, which may develop suddenly or progress slowly over time. Key signs to watch for include:

• Vaginal bleeding: While bleeding is common, it is not always present. Sometimes, blood may be trapped behind the placenta, so there is little or no visible bleeding.
• Abdominal pain: Sudden, severe pain in the abdomen or back is a hallmark symptom.
• Uterine tenderness or rigidity: The uterus may feel hard or tender to the touch.
• Frequent contractions: The mother may experience rapid, repeated uterine contractions.
• Foetal distress: Changes in the baby’s heart rate or decreased foetal movement may indicate a problem.

Diagnosis and Treatment

If you experience any symptoms of placental abruption, seek medical attention immediately. Diagnosis typically involves:

• Physical examination: Your healthcare provider will assess your symptoms and check for uterine tenderness or contractions.
• Ultrasound: While useful, ultrasounds do not always detect placental abruption, especially if the separation is small.
• Foetal monitoring: The baby’s heart rate will be closely monitored for signs of distress.

Treatment depends on the severity of the abruption, the gestational age of the baby, and the mother’s condition:

• Mild cases: If the abruption is mild and the baby is not close to full term, you may be hospitalized for close monitoring. If the bleeding stops and the baby is stable, you may be allowed to rest at home.
• Moderate to severe cases: If the abruption is severe, immediate delivery—often by caesarean section—is necessary to protect both mother and baby. Blood transfusions or other supportive care may be required.
• Preterm babies: If delivery is required before the baby’s lungs are mature, corticosteroids may be given to help the baby’s lungs develop more quickly.

Prevention and Care

While not all cases of placental abruption can be prevented, certain steps can help reduce your risk:

• Regular prenatal care: Attending all scheduled check-ups allows for early detection and management of risk factors.
• Managing chronic conditions: Controlling high blood pressure and avoiding smoking or substance use are crucial.
• Prompt reporting of symptoms: If you experience any unusual symptoms, such as vaginal bleeding or severe abdominal pain, contact your healthcare provider immediately.

Conclusion

Placental abruption is a serious but manageable condition with prompt medical care. Being aware of the risk factors and symptoms, and seeking immediate help if they arise, can make a significant difference in the health and safety of both mother and baby. At Neotia Bhagirathi Woman and Child Care Centre, our expert team is dedicated to providing the highest standard of care for expectant mothers facing this and other pregnancy complications.