Placental abruption: what it is, symptoms, causes and treatment

Placental abruption occurs when the placenta is separated from the wall of the uterus prematurely, causing severe abdominal cramping and vaginal bleeding in pregnant women over 20 weeks of gestation.

This situation is delicate, as it can put the health of the mother and baby at risk, therefore, in case of suspicion, it is recommended to go immediately to the emergency room for consultation with the obstetrician, to diagnose and treat this situation as quickly as possible. .

If the detachment occurs at the beginning of pregnancy, or before 20 weeks, it is called ovular detachment, which presents very similar symptoms. See how to identify and what to do in case of ovular detachment.

Main symptoms

Placental abruption can cause signs and symptoms such as:

• Severe abdominal pain;
• Pain in the lower back;
• Vaginal bleeding.

There are cases in which vaginal bleeding is not present, as it can be hidden, that is, trapped between the placenta and the uterus.

Furthermore, if the detachment is small, or partial, it may not cause symptoms. However, if it is very large, or complete, the situation is more serious and, therefore, it is normal for the symptoms to be stronger and the bleeding to be more intense.

How to confirm the diagnosis

The diagnosis of placental abruption is made by the obstetrician, based on the clinical history and physical examination, in addition to performing an ultrasound, which can detect hematomas, clots and differentiate it from other conditions that can cause similar symptoms and bleeding, such as placenta previa. Learn more about this other important cause of bleeding and what to do in case of placenta previa.

What causes detachment

Any pregnant woman can develop placental abruption, however, it is more common for it to develop in women with risk factors that affect blood circulation, such as:

• Make very intense physical efforts;
• Having suffered a strong blow to the back or stomach;
• Have high blood pressure or pre-eclampsia;
• Being a smoker;
• Use drugs;
• The water breaks before the expected time;
• Having little amniotic fluid;
• Having a disease that alters blood clotting.

Placental abruption is one of the main causes of bleeding in the third trimester of pregnancy, a period when the fetus and placenta are larger. Treatment should be started as soon as suspected, to reduce the risk to the health of the baby and mother, due to the consequences of bleeding and lack of oxygen.

How the treatment is carried out

If you suspect placental abruption, you are advised to go to the emergency room as soon as possible so that the obstetrician can begin diagnostic and treatment procedures. It may be necessary for the pregnant woman to remain hospitalized for a period of time, resting, using oxygen and controlling blood pressure and heart rate, in addition to monitoring bleeding with blood tests.

To treat premature placental abruption, it is important to individualize each case, according to the number of weeks of gestation and the health status of the pregnant woman and the baby.

Thus, when the fetus is mature, or is more than 34 weeks old, the obstetrician normally recommends bringing forward the birth, with a natural delivery being possible when the abruption is small, but a cesarean section being necessary if the abruption is more severe.

When the baby is less than 34 weeks pregnant, constant evaluation must be carried out until the bleeding stops and until your vital signs and those of the baby are stabilized. Medications may also be indicated to reduce uterine contraction.

Other important precautions

If the mother and baby are well and the bleeding stops, the pregnant woman can be discharged, with the guidance of some precautions such as:

• Avoid standing for more than 2 hours, preferably sitting or lying down with your legs slightly elevated;
• Not making any kind of effort such as cleaning the house or taking care of the children;
• Drink at least 2 liters of water per day.

If the condition cannot be stabilized, it may be necessary to bring the birth forward, even in these cases, to guarantee the health of the baby and mother.

As it is not possible to predict when placental abruption will or will not occur, it is important to carry out adequate prenatal care, making it possible to detect any changes in the formation of the placenta in advance, making it possible to intervene as soon as possible. Find out more about what the placenta is for and what changes may occur.