ABRUPTIO PLACENTA

General Information

DEFINITION--Partial separation of the placenta (after-birth) from the uterus during the last third of pregnancy.

BODY PARTS INVOLVED--Uterus.

SEX OR AGE MOST AFFECTED--Females.

SIGNS & SYMPTOMS

Small separation of the placenta:

• Vaginal bleeding.
• Mild pain or discomfort.
• Unborn child (fetus) remains healthy.

Large separation:

• Heavy vaginal bleeding.
• Severe pain in the lower abdomen.
• Hard, tender abdomen.
• Shock (rapid heartbeat, rapid breathing and dizziness).
• Fetal distress; fetal heartbeat may be inaudible.

CAUSES--Unknown.

RISK INCREASES WITH

• Women over age 35.
• Women who have had several pregnancies.
• Women who smoke.
• A direct blow to the uterus.
• High blood pressure.
• Abuse of alcohol or drugs.

HOW TO PREVENT

• If pregnant, don't engage in activity more vigorous than what you were accustomed to before pregnancy.
• Avoid risk factors if possible.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies, such as blood counts, blood-clotting tests and ultrasound examination (See Glossary) of the uterus.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization (except for mild cases).
• Surgery to deliver the fetus by cesarean section, or vaginal delivery (sometimes).

POSSIBLE COMPLICATIONS

• Shock or life-threatening bleeding in the mother.
• Child born brain damaged.

PROBABLE OUTCOME--

• With immediate medical care, the outlook for mother and fetus is excellent.
• With delay of medical care and prolonged heavy bleeding, mother and fetus may not survive.

How To Treat

GENERAL MEASURES----Abruptio placenta is an emergency, but there is usually time to obtain advice by telephone and arrange safe transportation to the hospital. Panic is not helpful. If the placenta separation is slight, your doctor may permit you to return home for bed rest and close observation after examination.

MEDICATION--Your doctor may prescribe:

• Oxytocin to induce labor, if immediate delivery is necessary.
• Intravenous fluids.
• Blood transfusions.

ACTIVITY--Rest in bed until bleeding and other symptoms cease and your doctor approves a return to normal activity.

DIET--No special diet. Drink fluids only until your doctor determines that surgery is not likely. Solid food may cause risk if emergency surgery becomes necessary.

Call Your Doctor If

You have bleeding (anything more than slight spotting) during pregnancy. This is an emergency!