A common condition that may develop during pregnancy is bleeding. This condition may be serious or not, but nevertheless requires immediate consultation with an obstetrician, and in some cases a trip to the emergency department. Heavy bleeding may be due to an uncommon pregnancy condition called placental abruption.
The placenta is the organ that links and connects the developing and growing fetus to a mother-to-be. It develops in the uterus during pregnancy and attaches itself to the uterine walls, supplying the fetus with oxygen and nutrients until the baby is delivered. When the placenta partially or completely detaches from the uterus before delivery, placental abruption occurs. The onset of this condition is sudden, and if left untreated compromises both mother and the unborn baby.
Statistics indicate that this condition occurs in one out of 100 pregnancies and is a serious threat in one out of every 1,500 pregnancies.
Complications of Placental Abruption
Heavy bleeding occurs when this condition happens and may result in hypovolemic shock. A decrease in the volume of blood plasma occurs, requiring immediate transfusion of blood. Hypovolemic shock could also lead to kidney failure. If bleeding is uncontrollable, hysterectomy may be required.
Placental abruption could result to premature births, stillbirths, and in some cases, infants born with abnormalities due to the deprivation of nutrients and oxygen.
Placental abruption usually happens in the last three months of gestation. This condition becomes more evident in the last few weeks of pregnancy.
The most obvious sign of probable placental abruption is bleeding in the vagina, which may be presented as minimal bleeding that manifests as clotted blood in the placenta after delivery. A moderate amount of bleeding is accompanied by uterine contractions, where the fetal heart rate is distressed, and the mother exhibiting low blood pressure. Concealed or severe vaginal bleeding comes with more persistent abdominal pain and steady contractions. The mother’s blood pressure could be extremely low, resulting in fetal death.
Aside from bleeding, contractions and abdominal pain, an expectant mother’s uterus and abdomen are firm to the touch yet shows signs of uterine tenderness. Back pain is a common symptom that may appear suddenly and intermittently. The amount of bleeding is not an indication as to the degree of the placenta separation from the uterus. There is a possibility for the blood to be trapped in the uterus so that no visible bleeding may be evident even if the condition is severe.
Chronic placental abruption happens when the condition slowly develops. Light and intermittent bleeding is an indication, which in turn affects the fetus’ growth and development. Oligohydramnios or low amniotic fluid and other growth and development problems could occur.
There is no specific cause for the onset of placental abruption. However, injury or trauma to the abdomen due to an accident is a possible cause. The loss of amniotic fluid that cushions the fetus may also lead to placental abruption.
There are issues that increases the risk of placental abruption and some of these factors are chronic hypertension of the mother during pregnancy that may lead to eclampsia or preeclampsia, smoking or cocaine use during pregnancy, infection in the uterus, or leaking of amniotic fluid due to early rupture of membranes.
If the mother experienced abdominal trauma during pregnancy, or is carrying more than one baby, the likelihood of placental abruption is increased. Pregnant women who are well over 40 years old are at risk of this condition. Women who have abnormalities in their uterus, and those who have had placental abruption in a previous pregnancy are more at risk.
There is no actual treatment to reattach a separated placenta to the uterus. However, there are certain things that a doctor can do to manage the condition, depending on the level of abruption.
If the abruption is mild and the bleeding has stopped, the doctor may allow the pregnant woman to go home but with close monitoring of her condition. She might be on complete bedrest for the duration of her pregnancy. If the bleeding has not stopped and the baby is far from full term, the physician might prescribe medications to hasten the baby’s lung development in case of a pre-term birth.
If the baby is close to full term, the doctor might go for an early delivery to avoid unnecessary complications to the mother and baby.
Placental abruption is not preventable, but one can take certain precautions to decrease the risk of developing this condition. A pregnant woman must stop smoking and using drugs. If she has high blood pressure, it is best to consult with a doctor to manage the condition before getting pregnant. Trauma to the abdomen can be minimized by practicing safety methods such as wearing of a seatbelt, using non-slip shoes, and other safety practices.