Placental abruption is a severe gestational complication. It is produced due to a complete or partial detachment between the placenta and the uterus wall, causing a decrease in oxygen transported to the fetus and severe blood loss in the mother.
Even though it is rare and can only occur from the 20th gestational week onward, it can happen during the 3rd trimester of the pregnancy.
It is caused by the rupture of retroplacental blood vessels. Other aspects that can increase the risk of placental abruption are the following:
- Chronic hypertension +/- acute hypertension during pregnancy
- Having a history of placental abruption, preeclampsia and/or delay of the intrauterine growth
- Multiple pregnancies
- Having more than 35 years old
- Abdominal traumatism
- Premature placental abruption and chorioamnionitis
- Tabaquism, alcohol and cocaine.
A few symptoms or no symptoms are manifested. Sometimes, a hemorrhage of dark or bright blood through the neck of the uterus and pain in the abdomen when palpating the area.
The diagnosis is done through clinical questioning and physical exploration of the gestating person. A gynecological ultrasound where a retroplacental hemorrhage can be seen must be done.
The treatment is based on ending the gestational period as soon as possible; generally, an urgent cesarean section will be practiced. If it is not done in time, it can represent a risk for the mother and the baby.
- Schmidt P, Skelly CL, Raines DA. Placental Abruption. 2020 Jul 5.
- Tikkanen M. Placental abruption: epidemiology, risk factors and consequences. Acta Obstet Gynecol Scand. 2011 Feb;90(2):140-9.
- Rodríguez E, Ruedas A, Morales C, Alegre A, Cabeza L. Manual CTO de Medicina y Cirugía Volumen II (2019). 87-89. CTO editorial.
