Premature placental abruption occurs when the placenta is separated from the wall of the uterus, causing severe abdominal cramping and vaginal bleeding in pregnant women over 20 weeks of gestation.
This is a delicate situation as it may endanger the health of the mother and the baby, so if it is suspected, it is advisable to go immediately to the emergency room to see the obstetrician to diagnose and treat this situation as soon as possible .
In addition, if a detachment occurs early in pregnancy, or before 20 weeks, it is called ovular detachment, which has very similar symptoms. If you want to know more about this situation, see how to identify and what to do in case of ovular detachment.
What causes
Any pregnant woman may develop a placental abruption, and the cause is associated with changes in blood circulation in the placenta and inflammation, which can be triggered by:
- Intense physical exertion;
- Bump on the back or belly;
- High blood pressure or pre-eclampsia;
- Smoking;
- Use of drugs;
- Breakage of the bag ahead of schedule;
- Little amniotic fluid in the bag;
- Infection;
- Diseases that change blood clotting.
Placental abruption is one of the leading causes of bleeding in the third trimester of pregnancy, period in which the fetus and placenta are larger. Your treatment should be started as soon as suspected to reduce the risk to the health of the baby and the mother due to the consequences of bleeding and lack of oxygen.
How is the treatment done?
In case of suspicion of premature detachment of the placenta, it is advised to go to the emergency room as soon as possible, in order for the obstetrician to begin the diagnostic and treatment procedures. It may be necessary for the pregnant woman to be hospitalized for a period of rest, with oxygen use and control of blood pressure and heart rate, as well as bleeding monitoring with blood tests.
In order to treat placental abruption, it is important to individualize each case according to the number of weeks of gestation and the state of health of the pregnant woman and the baby.
Thus, when the fetus is mature, or it is more than 34 weeks, the obstetrician usually recommends anticipating the delivery, and can be performed normal delivery when the detachment is small, but a cesarean section is necessary if the detachment is more severe.
When the baby is less than 34 weeks of gestation, a constant evaluation should be done until the bleeding stops and until his / her vital signs and those of the baby are stabilized. Medications may also be indicated to decrease contraction of the uterus.
Other orientations
If the mother and baby are well and the bleeding stops, the pregnant woman can be discharged, with the guidance of some care such as:
- Avoid standing more than 2 hours, preferably sitting or lying down with your legs slightly raised;
- Do not make any kind of effort like cleaning the house or taking care of the children;
- Drink at least 2 liters of water per day.
If it is not possible to stabilize the picture, it may be necessary to anticipate the delivery, even in these cases, to ensure the health of the baby and the mother.
As it is not possible to predict when the placenta detachment will occur or not, it is important to perform an adequate prenatal care, and it is possible to detect any changes in the placenta formation in advance, and it is possible to intervene as soon as possible. Learn more about what the placenta is for and what changes may occur.
How to know if it is placental abruption
Premature placental abruption may cause signs and symptoms, such as:
- Severe abdominal pain;
- Pain in the lower back;
- Vaginal bleeding.
There are cases where vaginal bleeding is not present, as it can be hidden, that is, be held between the plancer and the uterus.
In addition, if the detachment is small or partial, it may not cause symptoms, but if it is too large or too full, the situation is much worse, as the bleeding is more intense, as well as cutting off the oxygen source to the drink.
The diagnosis of premature detachment of the placenta is made by the obstetrician, from the clinical history and physical examination, besides the ultrasound, which can detect hematomas, clots, bleeding intensity and differentiate from other diseases that may confuse, such as placenta previa . Learn more about this other important cause of bleeding in pregnant women, and see what to do in case of placenta previa.
