What does placental abruption entail and how to intervene

Symptoms of placental abruption

Is there a way to notice that placental abruption is occurring? Yes, you need to look for the following symptoms:

• vaginal bleeding, which may not be present
• hardened uterus and strong and persistent contractions
• abdominal pain with each contraction, which may extend to the back.

Blood loss may not occur if the detachment is in the central part of the placenta. In this case, in fact, the blood infiltrates the uterus rather than finding a way to the outside.
This is not to say that if you have no or few losses, you should underestimate the situation.
Try to pay attention to the movements of the fetus too: if as a mother you feel that the baby is moving less than usual, it is better to consult your doctor immediately or go to the emergency room for a thorough examination. It may be that it is nothing, or that other less serious causes are at play, but it is always best to check.
If the placental abruption is small or in any case proceeds slowly, it is still necessary to undergo further and specific medical checks: the situation could reveal a growth retardation or a reduced amount of amniotic fluid that is not sufficient for the fetus.

The underlying causes of placental abruption

It is always very difficult to understand what causes a placental abruption. Abdominal trauma, following car accidents or accidental falls, are certainly among the best known. Here is a list of other factors to consider:

• predisposition (placental abruption that has already occurred in previous pregnancies)
• addiction to smoking
• age of the mother over 35/40 years
• uterine infections
• hypertension
• twin pregnancy, which leads to excessive distension of the uterus, as well as the presence of large amounts of amniotic fluid
• consumption of cocaine and other drugs

Detachment of the placenta: what it means for the mother and the baby

As for the baby, a minimal placental abruption is not considered dangerous for him, but the situation must be constantly monitored. When, on the other hand, the detachment of the placenta is massive, the baby no longer receives enough nutrients and oxygen, resulting in fetal suffering with even significant restrictions on growth, up to death in utero. The "only way out", but which involves risks, is premature birth.
As for the mother, however, if the abruption of the placenta is accompanied by significant blood loss, a blood transfusion will be necessary.
If the bleeding continues after delivery, it will be necessary to proceed with the removal of the uterus (hysterectomy).
For moms who have had a placental abruption there could be long-term consequences. Among all, the high risk of mortality from cardiovascular diseases should be noted.

Diagnosis and intervention

To diagnose a placental abruption, it is necessary to undergo an ultrasound scan, in addition to the classic clinical analyzes. If the detachment is very visible, ultrasound will be able to identify it; in other cases, a clinical diagnosis will be necessary.

How is it done?

• If the gap is minimal

If the situation is not serious, placental abruption is minimal and the fetus shows no signs of distress, you can try to take your time and see what happens. Hospitalization may be necessary for the mother to be constantly monitored. If the conditions for an emergency birth are met, corticosteroid drugs are tried to be administered to the fetus to promote the maturation of the fetal lungs.

• If the abruption of the placenta is complete or nearly complete

If, on the other hand, the situation is critical and the placenta has completely or almost detached, it will be very likely that the fetus shows signs of suffering: the only possibility in these cases is to resort to an emergency caesarean section.

Is it possible to prevent placental abruption?

Placental abruption is a condition that occurs in "1% of pregnancies, so fortunately it can be considered a rare event. But there is another interesting fact: the more serious forms, which involve an almost complete detachment of the placenta and can lead to the death of the fetus in utero, are even more rare, affecting women in one birth every 800-1600.
There is no prevention protocol to follow to avoid placental abruption, it goes without saying that it must be the intention of the future mother to abstain from smoking, drugs and other risk factors that we have mentioned in the previous paragraphs. It is also true that if there are predisposing conditions, (example: twin pregnancies or hypertension), the pregnancy will have to be followed very carefully, with frequent and targeted checks.

Frequently asked questions about placental abruption

Does having a low placenta mean that you are more at risk for a placental abruption?

If you have been diagnosed with low-lying placenta, before you panic and think that this means it is easier for you to go into detachment, read below. The low placenta consists of the insertion of the placental membrane in the lower part of the uterus, at the cervix. As the pregnancy progresses and the fetus grows, the lower placenta tends to be "pulled" upwards, thus clearing the birth canal. There is therefore no correlation between low placenta and the risk of detachment.

The premature detachment of the placenta occurs when it detaches from the wall of the uterus to which it is "anchored". This usually happens after the first 20 weeks of pregnancy. Symptoms can be vaginal bleeding and / or severe abdominal pain. If the detachment occurs earlier, it is usually never serious, and a little rest as well as continuous medical monitoring will be enough to avoid any kind of problem.

Once the placenta is detached, it cannot heal. If the detachment is slight and does not involve risks for the fetus, with some small precautions and continuous medical visits, you can carry out the pregnancy without problems. If the gap is greater, your doctor will direct you to a path of targeted care and treatment.