Navigate Up

Pediatric Center - A-Z Index

#
Q
Z

Print This Page

Placenta abruptio

Placenta abruptio is the separation of the placenta (the organ that nourishes the fetus) from its attachment to the uterus wall before the baby is delivered.

Alternative Names

Premature separation of placenta; Ablatio placentae; Abruptio placentae; Placental abruption

Causes, incidence, and risk factors

The exact cause of a placental abruption may be hard to determine.

Direct causes are rare, but include:

  • Injury to the belly area (abdomen) from a fall, hit to the abdomen, or automobile accident
  • Sudden loss of uterine volume (can occur with rapid loss of amniotic fluid or after a first twin is delivered)

Risk factors include:

  • Blood clotting disorders (thrombophilias)
  • Cigarette smoking
  • Cocaine use
  • Diabetes
  • Drinking more than 14 alcoholic drinks per week during pregnancy
  • High blood pressure during pregnancy (about half of placental abruptions that lead to the baby's death are linked to high blood pressure)
  • History of placenta abruptio
  • Increased uterine distention (may occur with multiple pregnancies or very large volume of amniotic fluid)
  • Large number of past deliveries
  • Older mother
  • Premature rupture of membranes (the bag of water breaks before 37 weeks into the pregnancy)
  • Uterine fibroids

Placental abruption, which includes any amount of placental separation before delivery, occurs in about 1 out of 150 deliveries. The severe form, which can cause the baby to die, occurs only in about 1 out of 800 to 1,600 deliveries.

Symptoms

Signs and tests

Tests may include:

Treatment

Treatment may include fluids through a vein (IV) and blood transfusions. The mother will be carefully monitored for symptoms of shock . The unborn baby will be watched for signs of distress, which includes an abnormal heart rate.

An emergency cesarean section may be needed. If the baby is very premature and there is only a small placental separation, the mother may be kept in the hospital for close observation. She may be released after several days if the condition does not get worse and any bleeding stops.

If the fetus is developed enough, vaginal delivery may be done if it is safe for the mother and child. Otherwise, a cesarean section will be done.

Expectations (prognosis)

The mother does not usually die of this condition. But any of the following increases the risk of death for both the mother and baby:

  • Closed cervix
  • Delayed diagnosis and treatment of placental abruption
  • Excessive blood loss, leading to shock
  • Hidden (concealed) uterine bleeding in pregnancy
  • No labor

Fetal distress occurs early in the condition in about half of all cases. Infants who live have a 40-50% chance of complications, which range from mild to severe.

Complications

Excess blood loss can lead to shock and possible death of the mother or baby. If bleeding occurs after the delivery and blood loss cannot be controlled in other ways, the mother may need a hysterectomy (removal of the uterus).

Calling your health care provider

Call your health care provider right away if:

  • You are in an auto accident, even if the accident is minor.
  • You fall and hit your abdomen.
  • You have vaginal bleeding during pregnancy.

See your health care provider right away, call your local emergency number (such as 911), or go to the emergency room if you have vaginal bleeding and severe abdominal pain or contractions during your pregnancy. Placental abruption can quickly become an emergency condition that threatens the life of both the mother and baby.

Prevention

Do not drink any alcohol, such as beer and wine. Do not smoke or use recreational drugs during pregnancy. Get early and regular prenatal care.

Recognizing and managing conditions in the mother such as diabetes and high blood pressure also decrease the risk of placental abruption.

References

Francois KE, Foley MR. Antepartum and postpartum hemorrhage. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics - Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 19.

Houry DE, Salhi BA. Acute complications of pregnancy. In: Marx J, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, PA: Elsevier Mosby; 2009:chap 176.

Cunningham FG, Leveno KL, Bloom SL, et al. Obstetrical hemorrhage. In: Cunningham FG, Leveno KL, Bloom SL, et al., eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 35.

Updated: 11/8/2012

Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com