by Christobel Rajesh

Created on: July 17, 2008   Last Updated: June 15, 2009

The definition of placental abruption can be stated as premature seperation of a normally situated placenta occuring after the 22nd week of pregnancy. The exact cause of placental abruption is still not clear, but there are various reasons that are suspected to cause placental abruption.

Some causes are,
1. Pregnancy induced hypertension

2. Sudden reduction in uterine size

3. Unskilled hands performing external cephalic version

4. Possibility of cord pulling after the birth of first twin

5. Direct trauma to the abdomen that may dislodge the placenta.

Blood loss from a placental abruption may be defined as revealed, concealed or mixed haemorrhage. When the placenta seperates there can be minimal or severe bleeding depending upon partial or complete seperation. The blood escaping from the placental site and draining through the vagina is called as revealed haemorrhage. Blood can sometimes retain back between the placenta and muscle fibres giving uterus a oedamatous appearance and this is called as concealed haemorrhage. There can be some visible bleeding and some absorption taking place which is termed as mixed haemorrhage.

Pregnancy induced hypertension is the cause of most placental abruptions. A recent history of headaches, nausea, vomiting, epigastric pain and visual disturbances may be a feature. Road traffic accidents are probably the next most likely cause that may result in trauma to the abdomen. External cephalic version injudiciously performed leads to placental seperation, but it is very rare.

The signs and symptoms are abdominal pain, blood loss, edema of the face, fingers, limbs and around the eyes. Blood pressure will be low and pulse rate will be high indicating shock. The fetal heart will not be heard through fetal stethoscope and the fetal parts will not be palpable. This is because of concealed haemorrhage. An immediate ultrasound should be taken. If bleeding is severe, fetal death is the common outcome.

This condition is treated as a obstetric emergency. The mother is kept in a emergency unit and fetal monitoring is done. She will be given pain relievers, blood products and fluids to combat blood loss. If the bleeding is mild, the mother is made to rest with the legs elevated and will be closely monitored.

Any bleeding with pain or no pain is not expected at any stage of pregnancy. It should be reported immediately to the doctor. Any history of placental abruption should also be reported to the physician during the regular checkups of current pregnancy.

Learn more about this author, Christobel Rajesh.
Click here to send this author comments or questions.