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All your pregnancy questions answered

Abruptio placenta [placental separation]

• What is an abruptio placenta?

An abruptio placenta is also known as placental abruption or placental separation. It occurs when the placenta separates from the wall of the uterus before the baby has been born. Along with placenta praevia it forms amongst the most common causes of vaginal bleeding in late pregnancy. It is a serious condition and is a pregnancy emergency and needs to be handled with urgency.

• Causes of placental abruption

1. Over half the cases of placental abruption are due to hypertension or high blood pressure. This may be a hypertension that was preexisting before the patient got pregnant or it could be a pregnancy induced hypertension [PIH]

2. Injury or trauma to the abdomen

3. Sudden release of the amniotic fluid in Hydramnios [excessive fluid in the uterus]

4. Twin pregnancy

5. Tumours of the uterus

6. Folic acid deficiency

7. Excessive alcohol consumption in pregnancy

• How is it diagnosed and treated?

Usually the woman complains of sudden bleeding from the vagina with or without pain and she needs immediate admission to the hospital. The first test that is done is an ultrasound to locate where the placenta lies and to differentiate between a placenta praevia and a placental abruption.

Once a placental abruption has been confirmed the treatment depends on various factors such as

1. Severity of bleeding and the woman's haemoglobin level

2. Presence or absence of hypertension

3. Number of weeks of pregnancy

4. Whether the baby is alive or not

5. Whether the patient is already in labour or not

If the baby is alive, reasonably mature and the bleeding does not seem to stop the woman is usually delivered by a caesarian section. If the patient is already in labour and blood loss has not been much your doctor may try to give you a normal delivery.

As usual if you have a Rh negative blood group an Anti D injection will be given to you.