Placenta abruptio

Alternative names:

ablatio placentae; abruptio placentae; accidental hemorrhage; premature separation of placenta

Treatment:

Treatment includes IV (intravenous) fluid replacement, blood transfusion, and careful monitoring of the mother for signs/symptoms of shock and for signs of fetal distress (abnormal fetal heart rate changes, in relation to contractions, and/or violent fetal movements). In the event of an immature fetus and evidence of only a small placental separation, the mother may be hospitalized for observation and released after several days if no evidence of progressing abruptio occurs. If the fetus is mature, vaginal delivery may be chosen if maternal and fetal distress is minimal; otherwise, a cesarean section may be the preferred choice to protect the mother and the child.

Expectations (prognosis):

Maternal death rates, in various parts of the world range from 0.5 to 5% . Early diagnosis of the condition and adequate intervention should decrease the maternal death rate to 0.5 to 1%. Fetal death rates range from 50 to 80%. Upon hospital admission, no fetal heart tone is detectable in about 15% of cases. Fetal distress appears early in the condition in approximately 50% of cases. The infants who live have a 40 to 50% incidence of illness. Concealed vaginal bleeding in pregnancy, excessive loss of blood resulting in shock, absence of labor, a closed cervix, and delayed diagnosis and treatment are unfavorable factors that may increase the risk of maternal or fetal death.

Complications:

Excessive loss of blood that may lead to shock and possible fetal and/or maternal death is the most evident complication. If the site of placental attachment starts to hemorrhage after the delivery and loss of blood cannot be controlled by other means, a hysterectomy (removal of the uterus) may become necessary.

Calling your health care provider:

Call your health care provider if you are pregnant and symptoms of placenta abruptio develop; this may rapidly become an emergency condition that threatens both the mother and the baby.