Placental abruption (also known as abruption placentae) is a medical complication that occurs during pregnancy wherein the placental lining separates, either partially or completely, from the wall of the mother’s uterus prior to delivery. Occurring in approximately 1% of all pregnancies, placental abruption can result in severe health consequences for both the mother and unborn fetus, including the risk of developing cerebral palsy (CP).
This abnormal detachment of the placenta can occur any time after the 20th week of a woman’s pregnancy. Symptoms for placental abruption include extreme abdominal or back pain, vaginal bleeding, frequent or continuous uterine contractions and/or back pain. A woman experiencing these symptoms should immediately contact their primary care giver or go to the emergency room. Placental abruptions are seldom fatal to the mother, but if not dealt with swiftly and correctly, can result in death to the unborn child.
Vaginal bleeding during pregnancy should always be brought to your doctor’s attention, but the amount of blood does not automatically indicate the severity of an abruption, if in fact, one has occurred. Blood may be blocked from exiting the body, trapped between the uterine wall and placenta. Your doctor will assess your condition and make his diagnosis based on a physical exam combined with your previous medical history.
If the doctor has not ruled out placental abruption, he may conduct an ultrasound. Ultrasounds can show if the placenta has separated from the uterus, but are only capable of verifying a placental abruption approximately 50% of the time. A negative ultrasound does not automatically mean you are in the clear. The doctor may also employ a fetal heart monitor to look for indications of fetal distress and to track uterine contractions. If the doctor has still not ruled out an abruption, he may check you for anemia. Women experiencing placental abruption are prone to anemia due to the loss of blood.
The placenta is the source of the unborn fetus’s blood, oxygen and nourishment. A placental abruption compromises the connection between the fetus and mother’s uterus and can deprive the baby of his oxygen supply for a period long enough to result in a stillbirth, premature birth or future developmental and/or growth issues. Oxygen deprivation to a fetus can cause brain damage. When this occurs, parts of the brain actually die, which can progress into motor skill issues, developmental issues and other symptoms common to cerebral palsy.
If it is determined that a placental abruption has likely occurred, the doctor will initiate a course of action based on the severity of the abruption, the impact on the unborn child and the proximity to the mother’s due date. If the abruption is deemed severe, an emergency Cesarean section may be the next step. Otherwise, the mother and baby will remain closely monitored until the doctor trusts that both are in the clear. The mother may be administered intravenous fluids or blood transfusions depending on how blood much she lost. The fetus will be monitored for signs of distress and will likely be hooked up to a fetal heart monitor. Mild abruptions have the ability to heal themselves.
Even if the doctor feels this is an emergency C-section is not necessary, he may still feel that a scheduled C-section, as opposed to a vaginal birth, is the safest course of action at this point.
Proper prenatal care is the best way to prevent this and many other complications. Avoid drinking alcohol, smoking or using recreational drugs during pregnancy. Be forthcoming about your pre-existing medical conditions such as diabetes or high blood pressure.
In some cases, placental abruption, which can lead to cerebral palsy, can also be caused by traumatic events to the mother’s body such as a fall or a car accident. Always notify your doctor if you experience a physical trauma during pregnancy. For more information about placental abruption, please visit the Cerebral Palsy Family Network.