The placenta is a mass of tissue which forms a connection between the uterus of a pregnant woman and the developing fetus. This tissue serves as an exchange point to provide the fetus with oxygen and nutrients, and to remove metabolic waste and carbon dioxide. During a typical healthy pregnancy, the placenta remains connected right up until birth, continuing to supply the fetus with essential nutrients. In abruptio placentae, the placenta pulls away from the uterus earlier than normal; generally the risk of this occurring begins after the twentieth week of pregnancy. Abruptio placentae is also known as placental abruption, abruption placentae, and placenta previa abruptio.
While the underlying causes of placental abruption are unknown, there are several factors which can increase the risk of this condition occurring. Women with heart disease, high blood pressure, diabetes, or arthritis are all at increased risk. Cigarette smoking, heavy alcohol use, or cocaine use, can also increase the risk. Traumatic injury such as that sustained in a fall or traffic accident may also cause placental abruption.
Symptoms of abruptio placentae include abdominal or back pain, uterine cramps or contractions, and vaginal bleeding. Women who experience any of these abruptio placentae symptoms should seek emergency medical care immediately, as the condition can be fatal for the woman or the fetus if left untreated. If proper medical care is obtained, however, the fatality risk is very low.
Diagnosis of placental abruption is made on the basis of several diagnostic tests, which may include blood tests such as hemoglobin, platelet, and fibrin counts. These blood tests indicate whether abnormal amounts of bleeding are occurring in the body. The diagnostic process is also likely to include an ultrasound, which is used to determine where in the uterus the placenta is located. This test is used to exclude a diagnosis of another condition called placenta previa, in which the placenta becomes implanted over the cervix.
Women who experience a mild form of abruptio placentae can usually remain at home, with bed rest advised until they are no longer in danger. In more severe cases, the woman may be hospitalized. Inpatient treatment may include oxygen treatment and fetal heart-rate monitoring, ultrasonography, and blood tests to monitor the health of the fetus. Rarely, it may be necessary to deliver the fetus via Cesarean; this is carried out only if there is a risk of fatality if the procedure is not performed.