Placental abruption occurs when the placenta is separated from the wall of the uterus, causing severe abdominal colic and vaginal bleeding in pregnant women over 20 weeks of gestation.
This situation is delicate, as it can endanger the health of the mother and baby, so in case of suspicion, it is recommended to go immediately to the emergency room to see the obstetrician, to diagnose and treat this situation as soon as possible.
In addition, if a detachment occurs in early pregnancy, or before 20 weeks, it is called ovular detachment, which has very similar symptoms. If you want to know more about this situation, see how to identify and what to do in case of ovular detachment.
What causes
Any pregnant woman can develop a placental detachment, and its cause is associated with changes in blood circulation in the placenta and inflammation, which can be triggered by:
- Intense physical exertion; Stroke in the back or belly; High blood pressure or pre-eclampsia; Smoking; Drug use; Bag rupture before expected; Little amniotic fluid in the bag; Infection; Diseases that alter blood clotting.
Placental detachment is a major cause of bleeding in the third trimester of pregnancy, the period when the fetus and placenta are greater. Your treatment should be started as soon as suspected, to reduce the risk to the baby's and mother's health, due to the consequences of bleeding and lack of oxygen.
How the treatment is done
In case of suspected placental abruption, it is advisable to go to the emergency room as soon as possible, so that the obstetrician begins the diagnostic and treatment procedures. It may be necessary for the pregnant woman to be hospitalized for a period, at rest, using oxygen and controlling blood pressure and heart rate, in addition to monitoring bleeding with blood tests.
To treat placental abruption, it is important to individualize each case, according to the number of weeks of gestation and the state of health of the pregnant woman and the baby.
Thus, when the fetus is mature, or more than 34 weeks old, the obstetrician usually recommends anticipating delivery, and a normal delivery can be done when the detachment is small, but it is necessary to have a cesarean if the detachment is more severe.
When the baby is less than 34 weeks pregnant, a constant evaluation must be done until the bleeding stops and until his vital signs and those of the baby are stabilized. Medications to decrease the contraction of the uterus may also be indicated.
Other guidelines
If the mother and baby are well and the bleeding stops, the pregnant woman may be discharged, with the guidance of some precautions such as:
- Avoid standing more than 2 hours, preferably sitting or lying with your legs slightly elevated; Do not make any effort such as cleaning the house or taking care of children; Drink at least 2 liters of water per day.
If it is not possible to stabilize the condition, it may be necessary to anticipate delivery, even in these cases, to ensure the health of the baby and the mother.
As it is not possible to predict when placental detachment will occur or not, it is important to perform adequate prenatal care, and it is possible to detect any change in the formation of the placenta in advance, making it possible to intervene as soon as possible. Find out more what the placenta is for and what changes may arise.
How to tell if it's placental detachment
The placental abruption can cause signs and symptoms, such as:
- Severe abdominal pain; Pain in the lower back; Vaginal bleeding.
There are cases in which vaginal bleeding is not present, as it can be hidden, that is, be trapped between the placenta and the uterus.
In addition, if the detachment is small or partial, it may not cause symptoms, but if it is very large or complete, the situation is much more serious, as the bleeding is more intense, in addition to cutting off the oxygen source for the baby.
The diagnosis of placental abruption is made by the obstetrician, based on clinical history and physical examination, in addition to ultrasound, which can detect bruises, clots, bleeding intensity and differentiate from other diseases that can confuse, such as placenta previa. Find out more about this other important cause of bleeding in pregnant women, and see what to do in case of a placenta previa.
