The placenta is a fundamental part of pregnancy. It is responsible for the delivery of oxygen and nutrients necessary for the baby’s growth. Placental abruption poses risks to pregnancy1, because when it occurs, depending on its severity, it may lead to preterm birth or unfortunately result in the baby’s death.
Risks of Placental Abruption
These risks occur because, with the detachment of the placenta from the uterine wall (where it should remain until the end of pregnancy), the transfer of all the benefits from the mother’s body to the baby through this temporary organ is compromised.
Placenta’s Role in Pregnancy
For the mother’s body to the baby, the placenta also acts as a kind of barrier that determines what should or should not reach the baby, such as bacteria and diseases2. That’s why some medications are forbidden—they can cross this protective placental barrier. In addition to all nutrients, the placenta also secretes several hormones that are essential for a healthy pregnancy, so placental abruption should be detected as soon as possible.
Placental abruption commonly happens after the start of the 3rd trimester of pregnancy, that is, after the 27th week. However, nothing prevents this abruption from occurring before that time. In the early weeks of pregnancy, the feared abruption is of the gestational sac, but these are different issues. The sac houses the baby when it is much smaller than during the stage when placental abruption is likely to occur, around the 7th month of pregnancy.
What Is Placental Abruption
We can say that placental abruption occurs when the organ becomes detached from the location where it is fixed. Because of this, there may be an accumulation of blood or entry of air between the uterine wall and the placenta and, consequently, the creation of space between the uterine wall and the placental membrane.
Causes of Placental Abruption
There are various causes of placental abruption, the main ones being hypertension or DHEG (hypertensive disorder unique to pregnancy) and diabetes. But it can also happen due to:
- Excess amniotic fluid (polyhydramnios)
- Extremely low blood pressure (hypotension)
- Blood clotting problems
- Smoking or drug use
- Accidents or severe impacts to the abdominal or thoracic region, such as falls or trauma from a car accident
- Bicornuate or didelphic uterus3
If the pregnant woman has any of these conditions, the doctor will be on alert and at any sign of abruption, will take appropriate and preventive measures.
Symptoms of Placental Abruption During Pregnancy
Placental abruption is characterized by abdominal and back pain and heavy bleeding, which may or may not be accompanied by amniotic fluid.
Placental abruption also has as one of its symptoms reduced movement of the baby, so if there is severe pain and decreased movement, you should go to the maternity emergency room or see your obstetrician. Frequent contractions are also a symptom of placental abruption.
Is Bleeding a Sign of Placental Abruption?
It is important to note that not all bleeding during pregnancy is a sign of placental abruption, but the cause should be investigated. Bleeding can occur due to placenta previa, uterine polyps, blood vessels breaking during sexual intercourse, and even hormonal drops.
Treatment
If the abruption occurs only with the gestational sac, at the beginning of pregnancy, the recommendation is absolute bed rest at home. In more severe cases, doctors will monitor the pregnancy and administer corticosteroid medications such as Celestone for the baby’s lung maturation.
Pregnancies less than 28 weeks gestation are considered extremely premature. In cases of premature placental abruption, the doctor will try to delay delivery as much as possible, but if there is fetal distress or risk, labor will be induced or an emergency cesarean section may be performed.
See also: Placental Grades – Understanding Grades 1, 2, and 3
