The placenta processes your baby’s nutrients, waste and oxygen by bridging your baby’s blood circulation with that of your own. It sits inside the womb alongside your baby, and is attached to the wall of the womb. It is linked to the baby by umbilical cord, which is attached to the baby’s abdomen.
Placental abruption (discussed here) and low-lying placenta are conditions linked to the placenta that can cause premature birth.
Placental abruption is a serious condition in which the placenta starts to come away from the inside of the womb wall before the baby has delivered. This is an emergency because it means that the support system for the baby is failing.
Studies show that placental abruption affects up to 1% of pregnancies (though it is suspected that the actual figure may be higher as it may not always be diagnosed). In this condition some or all of the placenta separates from the wall of the womb before the baby is delivered. This can be caused by an impact such as a car crash, or may be related to a condition such as pre-eclampsia or fetal growth restriction, also know n as Intrauterine growth restriction or IUGR.
When placenta abruption happens the placenta is damaged and the baby may not be supported to develop properly.
Symptoms of placental abruption
- pain in the back and abdomen
- tender womb
- vaginal bleeding.
If you are suffering from any of the symptoms above get medical help immediately because they may signify an emergency.
In most cases of placental abruption it will be diagnosed from obvious blood loss.
However it could also be a concealed or ‘silent’ abruption, in which the blood is trapped between the wall of the womb and the placenta so there is little or no bleeding. In this case it would be diagnosed when the woman reports pain in the back or abdomen.
The level of pain depends on the severity of the abruption. A less severe abruption may feel like a bruise. A severe abruption will be very painful.
Risk factors for placental abruption
Placental adruption is more likely if the mother:
- had a previous placental abruption
- is a smoker
- is a cocaine or amphetamine user
- has chronic high blood pressure
- has pre-eclampsia
- has had a blow to the stomach or an indirect trauma that may have affected the placenta
- has an intrauterine infection.
To reduce your risk avoid smoking in pregnancy and taking street drugs in pregnancy.
What does placental abruption mean for me and my baby?
The effects and treatment of placental abruption depend on how severe it is. If you are under 34 weeks and only a small part of the placenta has broken away from the womb you will be monitored closely to make sure the baby is growing properly and to watch for signs of labour starting.
If there is a risk of your baby not growing properly then labour may be induced.
If the abruption is more severe, you are losing lots of blood and the baby is in distress or at risk of not growing properly you may need to have your labour induced or have an emergency caesarean.
In addition to any problems that the baby may have from the placental abruption, there are health risks of being delivered early. These depend on how far into the pregnancy you are.
- BMJ Best Practice (accessed Sept 2016) http://bestpractice.bmj.com/best-practice/monograph/1117/basics/epidemiology.html
- BMJ Best Practice (accessed Sept 2016) http://bestpractice.bmj.com/best-practice/monograph/1117/basics/aetiology.html
- BMJ Best Practice (accessed Sept 2016) http://bestpractice.bmj.com/best-practice/monograph/1117.html
- J David, Steer P et al (2010) High risk pregnancy, management options, Elsevier Saunders
- RCOG (2011) Antepartum Haemorrhage, Green-top guideline 63, Royal College of Obstetricians and Gynaecologists
- BMJ Best Practice (accessed Sept 2016) http://bestpractice.bmj.com/best-practice/monograph/1117/diagnosis/history-and-examination.html
- BMJ Best Practice (accessed Sept 2016) http://bestpractice.bmj.com/best-practice/monograph/1117/treatment/step-by-step.html
ℹLast reviewed on September 1st, 2016. Next review date September 1st, 2019.