Premature Placental Abruption

Premature Placental Abruption

Premature placenta detachment (abruptio placentae) is a very serious complication during pregnancy that endangers the life and health of the unborn child and the mother.

What is premature placenta abruption?

As a rule, if a premature placenta detachment is detected, a caesarean section is initiated as quickly as possible, provided the child is already viable. Statistically, less than one percent of all natural pregnancies result in premature placental detachment. For carpal tunnel syndrome (cts), please visit nonprofitdictionary.com.

Premature placenta detachment occurs when the so-called placenta – which serves to supply the unborn child with nutrients – either partially or completely detaches from the uterus before the child is born.

As a result of the detachment, uterine bleeding occurs, ie bleeding in the uterus. If left untreated, these in turn lead to shock from blood loss (haemorrhagic shock) in the mother and to an acute undersupply of oxygen to the unborn child (hypoxia) up to and including death of the child due to lack of oxygen.

Causes

The cause of a premature placenta detachment can be, for example, a very violent blow or blow to the abdomen, which is suffered as part of a fall down stairs or a car accident.

Premature rupture of membranes – ie premature bursting of the amniotic sac before labor begins – can also cause premature placenta detachment. High blood pressure (hypertension) is considered a contributing factor, which is why pregnant women who suffer from high blood pressure are exposed to an increased risk (including other complications).

The probability of a premature placenta detachment increases with the number of previous pregnancies, ie the personal risk increases – statistically speaking – with each additional child.

Symptoms, Ailments & Signs

Premature placenta abruption affects women before the birth of one or more children. In a good third of all cases, there are no symptoms at all. The detachment can then only be detected with an ultrasound device. It turns out to be extremely small. In addition, advanced and severe forms that show typical symptoms can be distinguished.

In the case of an advanced detachment, women complain of sensitivity in the abdominal area. The lower abdomen is particularly affected. Pain occurs suddenly without any apparent reason. With this form of placental detachment, there is a small amount of bleeding from the vagina, also known as spotting.

The intensity of the bleeding in particular indicates the extent of the detachment. A strong discharge of blood from the vagina indicates a pronounced form. The pain in the abdominal area is then severe. They are constant and continue to intensify. If there is a large blood loss, shock and coagulation disorders are typical.

Most pregnant women are anxious. The heart rate increases. In its most pronounced form, premature abruption of the placenta also affects the unborn child. This suffers from a lack of oxygen. The heartbeat changes abnormally. In rare cases, it even dies in the womb.

Diagnosis & course of disease

Premature placenta detachment is almost always associated with sudden, severe pain in the abdomen and is often accompanied by heavy bleeding, severe heart palpitations and severe circulatory problems.

The fact that there is a problem is usually noticed immediately, so that in almost all cases of premature placenta detachment, first aid is given quickly in the hospital. The confirmed diagnosis is made there either on the basis of an ultrasound examination or a coagulation test (of the mother’s blood).

Premature placenta detachment endangers both the life of the unborn child and the life of the mother – while about one percent of affected mothers lose their lives, the probability of losing the child varies between 10% and 50%, depending on the week of pregnancy and the child’s weight.

Although premature placenta detachment is a very rare pregnancy complication, it has the highest mortality rate of all common complications during pregnancy.

When should you go to the doctor?

The detachment of the placenta can naturally only occur in sexually mature girls or women who are pregnant. In principle, when a pregnancy is determined, a doctor should be consulted and the patient should work together. Expected and possible developments in the growth process of the fetus over the course of the entire pregnancy and childbirth must be discussed. The mother-to-be should inform herself extensively about the forthcoming changes and take the necessary precautions for the delivery process. A birth should under no circumstances take place without the presence of medical personnel due to the multitude of complications and adversities. In principle, an in-patient birth is advisable

Especially when assessing a high-risk pregnancy, a hospital should be visited at the latest when labor begins. If there are any irregularities or abnormalities during the birth, this is monitored by the midwives, nurses or doctors who are present. They react immediately so that no life-threatening situations arise for mother and child. If spotting occurs, unusual pain and open questions should be discussed with the medically trained obstetrician during the entire pregnancy and especially during the birth. The better existing complaints can be described, the faster the cause of the irregularities can often be documented.

Treatment & Therapy

As already mentioned, if the child is already viable and the diagnosis has been confirmed, an immediate caesarean section is almost always carried out, in which the child is surgically removed from the uterus.

If, on the other hand, the child is not viable, ie if the placenta detaches prematurely before the end of the 34th week of pregnancy or if the fetal development is delayed, an attempt can be made to reduce the contractions with medication in order to delay the necessary caesarean section until the unborn child is born reached viability (particularly with regard to lung maturity).

Prevention

The chances of preventing premature placenta detachment are slim. As already mentioned, the presence of high blood pressure in the mother is considered to be a significant risk factor that can be influenced. If the problem is known, this can be treated in the run-up to pregnancy either with medication or conventionally (reduction in body weight, change in diet, specific physical activities).

In addition, the risk of premature placenta detachment increases with the number of previous pregnancies, which is why mothers at risk are sometimes advised not to have another pregnancy.

Furthermore, during pregnancy – but also for other health reasons – the exercise of physically demanding or dangerous activities should be avoided as far as possible, in the course of which trauma in the abdominal region and thus the triggering of a premature placenta detachment could occur.

Aftercare

A premature abruption of the placenta during pregnancy is always an intensive care emergency, as the lives of mother and child are at risk. There is severe internal bleeding and the placenta and uterus often have to be surgically removed. Because of the many possible complications, follow-up care after a placental abruption is very important.

Excessive blood loss can debilitate the affected woman and lead to anemia. Here, as part of the aftercare, it must be checked whether the body has already recovered from the blood loss or whether further measures are necessary. Follow-up care is particularly important in the case of a caesarean birth and possible removal of the entire uterus in order to check the wounds that have occurred postoperatively.

The wound healing is examined here during the aftercare as well as any pain, the cause of which can be further investigated via ultrasound. Placental abruption is a serious emergency that makes it particularly important for sufferers to attend their follow-up appointments after the event. Other, sometimes life-threatening complications such as renewed internal bleeding or delayed wound healing can usually be avoided through close follow-up care, but require the patient’s cooperation.

You can do that yourself

Premature placenta abruption is a medical emergency. After a fall or signs of placenta detachment, the first step is to call emergency services. The affected woman must then lie down quietly. The paramedic must be informed of the situation. Treatment in the hospital is then required. The most important measure is to remain calm and inform the doctor at the hospital about the incident as thoroughly as possible.

Since the premature abruption of the placenta is often fatal, affected women often also need therapeutic support. This can be supported by discussions with the partner and other affected persons. Visiting a self-help group or registering in an Internet forum for affected parents are also possible supportive measures.

In addition, any pain that occurs in connection with the placenta detachment must be treated. It is important to take the prescribed painkillers. At best, this should be monitored by the partner or a relative, since the affected women are usually in a state of shock. After completion of the treatment, a discussion with the gynecologist and a therapist should be held again, in which open questions can be clarified.

Premature Placental Abruption