Abruptio placentae - Information on Placental Abruption

Abruptio placentae (placental abruption), the partial or complete separation of placenta from the uterine wall. It generally occurs after the 20th week of pregnancy but can happen earlier. The cause is unknown and it occurs in 1 in 200 pregnancies. The symptoms seen depend on the severity of placental separation and on the amount of blood loss. Blood lost from the placenta may pass through the cervix and vagina and be seen as an external haemorrhage, but it may also be retained inside the uterus (concealed haemorrhage) and thus hides the severity of the condition.

Slight separation may result in light blood loss and is best treated with bed rest. Monitoring of the placenta and the baby is carried out using ultra sound. A moderate separation is when a quarter of the placenta separates and between 500-1000 mls of blood are lost. A blood transfusion is needed and if the pregnancy is near term a caesarean may be performed. Severe separation causes contraction of the uterus, tenderness, shock and possibly foetal distress.

Up to 4 pints of blood may be lost, needing a rapid blood transfusion. A Caesarean section is carried out if the baby is near term, but if placental abruption occurs before the third trimester (28 to 38 weeks after conception) then the foetus has little chance of survival. This condition is one of the most common causes of late-pregnancy haemorrhage and is more common in women who have had two or more children.

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