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Placental abruption
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Placentalabruptionmeanstheplacentahasdetached(comeaway)fromthewalloftheuterus,
eitherpartlyortotally.Thiscancausebleedinginthemother.Itmayalsointerferewiththeunborn
babyssupplyofoxygenandnutrients,whichtheplacentaprovidesfromthemothersbloodstream
throughtheliningoftheuterus.
Doctorscannotreattachtheplacenta.Withoutpromptmedicaltreatment,aseverecaseof
placentalabruptioncanhavedireconsequencesforthemotherandherunbornchild,including
death.
Worldwide,placentalabruptionoccursinaboutonepregnancyinevery100.Inabouthalfofcases,
placentalabruptionismildandcanbemanagedbyongoingclosemonitoringofthemotherand
baby.About25percentofcasesaremoderate,whiletheremaining25percentthreatenthelifeof
bothbabyandmother.
Symptoms
Someofthesymptomsandsignsofmoderatetosevereplacentalabruptioninclude:
Bleeding,mostcommonlynoticedwhenthewomanstartsbleedingfromthevagina
Continuousabdominalpain
Continuouslowerbackpain
Painfulabdomen(belly)whentouched
Tenderandharduterus
Veryfrequentuterinecontractions
Fetaldistressforexample,abnormalheartrhythm.
Insomecases,bleedingmayoccurbutthebloodmayclotbetweentheplacentaandthewallof
theuterus,sovaginalbleedingmaybescantyorevennon-existent.Thisisknownasa
retroplacentalclot.
Abdominal traumaaninjurytothepregnantwomansabdomenmayteartheplacenta
fromthewalloftheuterus.Examplesofeventsthatmaycausethistypeofinjurycould
includeacaraccident,assaultorfall.
Uterine decompressionthisisasuddenlossofamnioticfluidfromtheuterus,which
cansucktheplacentafromtheuteruswall.Possiblecausesofuterinedecompression
includethebirthofthefirsttwin(ormultiple)orruptureofamnioticmembraneswhen
thereisexcessiveamnioticfluid.
Risk factors
Whiletheexactcauseinmostcasesisunknown,certainfactorsmakeapregnancymore
susceptibletoplacentalabruption.Riskfactorsmayinclude:
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Complications
Complicationsinseverecasescaninclude:
Decreasedoxygentothebaby,whichcouldleadtobraindamage
Stillbirth
Maternalbloodlossleadingtoshock
Emergencyhysterectomy(surgicalremovaloftheuterus)ifthebleedingcannotbe
controlled
Maternaldeathfromseverebloodloss.
Diagnosis
Thesymptomsandsignsofplacentalabruptioncanmimicthoseofotherpregnancyconditions,
suchasplacentapreviaandpre-eclampsia.Informationthatmaybeusedtodiagnoseplacental
abruptionincludes:
Medicalhistory
Physicalexamination,includingcheckingthetendernessandtoneoftheuterus
Internalexaminationofthevaginaandcervix,usingaspeculum
Bloodtests
Ultrasoundtochecktheplacenta
Fetalheartbeatmonitoring.
Sometimes,thediagnosisofplacentalabruptioncantbeconfirmeduntilchildbirth,whenthe
placentaisdeliveredwithanattachedbloodclotthatappearsoldratherthanfresh.Theplacentais
usuallysenttoalaboratoryforfurtherdiagnostictesting.
Treatment
Allcasesofsuspectedplacentalabruption,regardlessofseverity,shouldbecloselymonitoredto
protectthehealthandsafetyofthemotherandchild.Thismonitoringisusuallydoneinhospital
andshouldincluderegularchecksofthevitalsignsofbothmotherandbaby.Treatmentdepends
ontheseverityoftheconditionbutmayinclude:
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Prevention
Whileitisimpossibletopreventplacentalabruption,theriskcanbereduced.Suggestionsinclude:
Avoidallsubstancesduringpregnancyincludingcigarettes,alcohol,medicines(unless
prescribedbyyourdoctor)andstreetdrugs.
Controlhighbloodpressure.Consultwithyourdoctorforinformation,adviceand
treatment.
Reduceyourriskoftraumaforexample,wearaseatbeltwhentravellinginacarand
avoidthepossibilityoffalls.
Talktoyourdoctorifyouhavehadplacentalabruptioninapreviouspregnancy.
Takefolicacidasrecommendedbyyourdoctorormidwife.
AlwayscallanambulanceinanemergencyTel.000
Yourdoctor
Obstetrician
NURSE-ON-CALLTel.1300606024forexperthealthinformationandadvice(24hours,
7days)
Emergencydepartmentofyournearesthospital
Things to remember
Placentalabruptionmeanstheplacentahasdetachedfromthewalloftheuterus,either
partlyortotally.Thiscancausebleedinginthemotherandmayinterferewiththebabys
supplyofoxygenandnutrients.
Thecauseisunknowninmostcases,butriskfactorsmayincludematernalhighblood
pressure,abdominaltraumaandsubstancemisuse.
Withoutpromptmedicaltreatment,aseverecaseofplacentalabruptioncanhavedire
consequencesforthemotherandherunbornchild,includingdeath.
This page has been produced in consultation with, and approved by:
RoyalAustralianandNewZealandCollegeofObstetriciansandGynaecologists
Placentalabruption
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Contentonthiswebsiteisprovidedforeducationandinformationpurposesonly.Information
aboutatherapy,service,productortreatmentdoesnotimplyendorsementandisnotintendedto
replaceadvicefromyourdoctororotherregisteredhealthprofessional.Contenthasbeen
preparedforVictorianresidentsandwiderAustralianaudiences,andwasaccurateatthetimeof
publication.Readersshouldnotethat,overtime,currencyandcompletenessoftheinformation
maychange.Allusersareurgedtoalwaysseekadvicefromaregisteredhealthcareprofessional
fordiagnosisandanswerstotheirmedicalquestions.
Forthelatestupdatesandmoreinformation,visitwww.betterhealth.vic.gov.au
Copyight 1999/2015StateofVictoria.ReproducedfromtheBetterHealthChannel
(www.betterhealth.vic.gov.au)atnocostwithpermissionoftheVictorianMinisterforHealth.
Unauthorisedreproductionandotherusescomprisedinthecopyrightareprohibitedwithout
permission.
Placentalabruption
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