Abruptio placenta is a very serious and rare condition in pregnancy when part or all of the placenta separates from the uterine wall. This occurs in 1 out of 100 pregnancies and is the leading cause of fetal death in the third trimester. The fetus depends solely on the placental for oxygen and for food. One percent of fetuses die before birth, and 30-50% die during the birth process. Abruptio placenta can lead to maternal hemorrhage which can be dangerous. However, maternal death is rare.

The main symptom of abruptio placenta is bright red bleeding from the vagina. The bleeding does not always occur, though, because the blood can be trapped behind the placenta or the baby. Other symptoms include abdominal pain, tenderness around the belly, lower back pain, rigidity of the uterus, contractions, and decreased fetal movement.

RISK FACTORS

While the cause of abruptio placenta is generally not known, there are risk factors associated with it. The known risk factors are as follows:

1. High blood pressure, chronic or pregnancy induced (This is the most common risk factor.)

2. Trauma to the abdomen, such as in the case of domestic violence

3. Smoking

4. Cocaine use

5. Use of alcohol

6. Mother over 40 years of age

7. Previous abruptio placenta (increases the risk to 10%)

8. Premature rupture of the amniotic sac

TREATMENT

The diagnosis for abuptio placenta is made by ruling out any other possible causes of the symptoms. Sometimes an ultrasound is used to find the abruption, but it does not detect an abruption every time. If the baby is not in danger the mother will be hospitalized to allow the fetus to mature before delivery. A fetal monitor will be used to observe the baby's heart rate. If the bleeding is severe or there is apparent danger to the baby, a cesarean will be performed immediately.