Each year placental abruption affects between 2.5% and 3.8% of all pregnant women in India. Globally, 1 in every 100 pregnant individuals has placental abruption during gestation.
Knowing more about this condition and understanding placental abruption risk factors can help make pregnancies and deliveries, both safer and healthier.
The placenta is an organ that develops when a woman or a female-bodied person becomes pregnant. Its main role during pregnancy is to provide the growing foetus with oxygen and nutrients through the umbilical cord.
In a healthy pregnancy, the placenta is connected to the wall of the mother’s uterus. But in some instances, the placenta separates and moves away from the wall of the uterus. This condition is called placental abruption.
Placental abruption is a serious medical condition that can jeopardise the lives of the mother and foetus alike. When the placenta is not connected to the mother’s uterine wall, the foetus loses its access to nutrients and oxygen.
Quick treatment is imperative to ensure both mother and foetus are healthy and safe.
There are two placental abruption types.
- Partial placental abruption – This is where the placenta is partially detached from the mother’s uterine wall.
- Complete placental abruption – Here, the placenta is fully detached from the mother’s uterine wall.
In addition, placental abruption types are classified based on the severity of the abruption.
- Class 0 – This is usually an asymptomatic placental abruption. A small clot may be observed behind the placenta during testing.
- Class 1 – Mild vaginal bleeding, minor uterine irritability and slight tenderness in the belly or back.
- Class 2 – Moderately severe vaginal bleeding and a higher degree of uterine irritability & tenderness. While there is no maternal shock, foetal distress may be observed.
- Class 3 – Extremely severe vaginal bleeding, with high pain and tenderness. The uterus begins to feel extremely hard and stiff. The foetus will be in distress, and the mother will experience maternal shock.
Placental abruption is a very serious medical condition for both, the mother and her baby. Common complications due to placental abruption are as follows:
- Excessive blood loss leads to shock
- Blood clotting problems
- Organ failure
- Emergency hysterectomy
- Delayed foetal development
Mothers and loved ones should monitor the pregnancy closely to identify any of the symptoms of placental abruption and seek immediate treatment if necessary.
Yes, it’s been observed that individuals who experienced a placental abruption in one pregnancy have about a 15% chance of experiencing another placental abruption in future pregnancies too.
In fact, placental abruptions are seen to increase in frequency and severity after the first occurrence.
Placental abruption causes include the following:
- Maternal age above 35 years
- Premature water breaking
- Occurrence of placental abruption in past pregnancies
- Injury or physical trauma to the uterus
- Gestations with multiple foetuses
- Shorter umbilical cord
- Fibroids in the uterus
- Less amniotic fluid
Placental abruption typically occurs after 20 weeks of pregnancy. But it can happen before that in some cases. Placental abruption symptoms include the following:
- Abdominal pain and tenderness
- Back pain
- Vaginal bleeding
- Uterine irritability and hardening
- Contractions that are quick and painful
- Decreased or no foetal movement for long stretches of time
Placental abruption risk factors that make a person more vulnerable to the condition include the following:
- Risky lifestyle during pregnancy that can impact the foetus.
- Diabetes and high blood sugar (which affect amniotic fluid levels).
- Consuming drugs and/or alcohol.
- Uterine infection during pregnancy (such as chorioamnionitis)
- Blood clotting problems.
Mothers need to have a clean and careful lifestyle to give their babies the best chance and have a healthy life together.
The placental abruption test constitutes the following:
- Observation – The patient is admitted to the hospital for close monitoring. If any symptoms are observed, then a course of treatment is designed.
- Analysis of medical history and past pregnancies – The doctor also studies the patient’s medical and pregnancy history. The doctor may ask questions about unusual spotting, bleeding, pain or discomfort.
- Physical testing – The doctor may also do a physical test by checking any tenderness or stiffness in the uterus. They may include an ultrasound of the uterus and relevant blood tests to identify potential or existing abruption.
Based on the severity of the abruption, one of two placental abruption treatments may be given.
- Foetal delivery – If the foetus is above 34 weeks in age, then doctors will monitor the mother’s condition to decide if a vaginal delivery is possible or if the patient needs a C-section. If the symptoms of abruption worsen, then doctors will choose to deliver the baby through a C-section immediately.
- Monitoring & medication – This treatment is used only when the foetus is under 34 weeks old. The doctors will focus on getting the foetus as close to the term as possible to help them grow safely. Certain medications may be provided to the mother to reduce bleeding and pain. Other pharmaceuticals may be provided to keep the foetus safe and aid its development in the womb.
Placental abruption is a scary reality for pregnant individuals. But pregnant women and female-bodied individuals don’t need to handle this condition alone. Getting immediate medical care when any symptoms or complications are noticed can go a long way in keeping both mother and her baby safe.
Not only will pregnancy care and gynaecological support give the mother the best chance at safe labour, but it will also allow the baby to have a healthy and happy life.
The CK Birla Hospital is nationally-renowned for its premier gynaecological and obstetrics care. Our doctors have helped many women with placental abruption safely navigate pregnancy and birth. Our goal is to get your baby as close to term as possible, ensure safe delivery and help you have subsequent safe pregnancies too. Contact us today to schedule a consult with Dr. Deepika Aggarwal.