Placental abruption pregnancy
Placental abruption, as the name implies, is a condition wherein the placenta separates from the uterus while the baby is still in the womb. This separation could be partial or complete. Placental abruption is dangerous because the separation deprives the baby of oxygen as well as other nutrients. For the mother, this will mean bleeding, the severity of which will depend upon the degree of separation. Also, placental abruption can cause health problems for the child. In cases where the abruption goes unnoticed (most likely because it is too small) the baby is either delivered prematurely or in worst cases, stillborn.
This condition occurs sometime after 20 weeks but is more common in the third trimester.
Causes of placental abruption
While the exact cause of placental abruption remains unknown there are certain factors that sometimes contribute to this condition. If the pregnant woman has gestational diabetes then she could be vulnerable to placental abruption in the third trimester. Also, if the woman continues smoking through her pregnancy, she could put herself at risk. Some other factors like preeclampsia or gestational hypertension could also trigger a placental abruption.
Symptoms of placental abruption
The most obvious sign of placental abruption is vaginal bleeding. In this case, the blood will be dark red in color and the flow could range from being minor spotting to a quick rush depending on the level of abruption.
In certain cases however, the blood stays inside the uterus and there could be no bleeding at all. In such cases, there will be other signs like a cramping pain in the back, premature contractions or endless contractions. You could also experience pain in the abdomen and back, nausea, dizziness, and little or no movement of the baby. In some cases, especially towards the end of the term, this condition can cause the water to break and the woman will know it is placental abruption because the amniotic fluid that comes out will have blood traces along with it.
Usually doctors will look to deliver the baby as quickly as possible in these situations and it is safer for both the baby and the mother if the delivery is cesarean.
However, if the baby is still very premature then doctors will evaluate the severity of the abruption and try and delay the delivery for some more time. In the meanwhile, the mother is given medication for quick development of the lungs so that the baby can be delivered early. In any case, the decision of waiting or delivering is taken by weighing the risk of premature delivery against the risk of an abruption that could get worse.
Tests for diagnosis in Case of Placental Abruption
Doctors rely on ultrasound to diagnose placental abruption. The ultrasound detects blood, if any, in the uterus. Also, the ultrasound can determine the baby’s health and also find out if the baby is still getting sufficient oxygen. An ultrasound also helps confirm or rule out the possibility of placenta previa, yet another placental complication that causes vaginal bleeding.
Placental abruption treatment
Sadly, there is no way of mending a placental abruption. Nor is there a way to stop the placenta from separating any further from the uterus. So, the treatment for this condition only focuses on maintaining optimum health of the mother and the baby.
If the separation is small, the woman is admitted in the hospital and kept under observation. Doctors will closely monitor the baby’s movements and development. If the baby seems to be fine, the woman is kept under strict bed rest. This is in case the baby is still premature. If the woman is into her ninth month, and the baby’s lungs seem to have matured, then doctors will opt for a delivery.
In case of severe bleeding or major abruption, doctors will deliver the baby through C-section.
So, if you do start bleeding in your third trimester, try not to panic and focus on getting to the hospital. Do ensure, though, that you go to one which has amenities to conduct a C-section in emergencies.