Placental Abruption During Pregnancy? (Placental Abruption) - Don't be afraid, let's be aware of this

If you are a loving mother who is carrying a baby, how many questions, hopes, and even little fears do you have in your mind during this time? It is very normal. You want to protect your little one from everything until he comes into this world. So, you must have heard about the 'placenta' that brings everything from nutrition to oxygen to the baby. This placenta is like the lifeblood of the baby. But very rarely, this placenta can separate from the uterine wall before the baby is born. That is what we call placental abruption in medicine. Even though this name may sound scary, it is very important to be properly informed about this.

Simply put, what is placental abruption?

Imagine, there is a baby inside your uterus. The placenta is a special organ that is attached to the uterine wall. The baby is connected to this placenta through the umbilical cord. The baby receives nutrition from the things you eat and drink, oxygen from the air you breathe, all of this through this placenta. Also, this placenta removes the waste products produced in the baby's body. It is like a 'supply service' that provides everything to the baby.

Normally, the placenta separates from the uterus after the baby is born. However, in a condition called Placental Abruption , the placenta completely or partially separates from the uterine wall during pregnancy, before the baby is born. This can be dangerous for both you and your baby. Fortunately, this is not very common. It affects about one in 100 (1%) pregnant women.

How do we recognize this condition? What are the symptoms?

This condition is most often seen after 20 weeks of pregnancy , especially in the third trimester. Sometimes it can happen gradually, or it can happen suddenly.

Let's take a closer look at these two types of symptoms in the table below.

What are the risk factors that could cause this?

It is often difficult to find a specific cause for this, but some factors have been found to increase the risk.

• Having this condition in a previous pregnancy: If you've had this condition in a previous pregnancy, there's about a 10% chance it will happen again. So it's very important to tell your doctor.
• Smoking: This risk is higher for women who smoke before they become pregnant. Some studies suggest that the risk increases by about 40% for each year of smoking.
• Alcohol and drugs: Drinking alcohol and using drugs like cocaine during pregnancy greatly increases the risk of this.
• High Blood Pressure: Whether you had high blood pressure before you became pregnant or if it develops during pregnancy, it is essential to work with your doctor to manage it well.
• Amniotic fluid problems: This risk can increase if the sac containing the amniotic fluid that protects the baby ruptures prematurely or leaks fluid.
• Age: This risk is slightly higher for mothers over the age of 35, especially those over 40.
• Carrying more than one child:When there are multiple babies, such as twins, the placenta can separate after the first baby is born and before the second baby is born.
• Abdominal Trauma: Imagine you suddenly fell to the ground, hit your stomach somewhere, or suffered an injury to your abdomen, such as in a car accident. These things can also cause the placenta to separate. So always think about safety.

How does the doctor diagnose and treat this?

If you have any of the symptoms mentioned above, especially bleeding or stomach pain, you should go to a hospital or your doctor immediately . The doctor will examine you.

• A physical exam will be performed to check for tenderness and pain in your uterus.
• Several blood tests are performed.
• An ultrasound scan attempts to look inside the uterus and the condition of the placenta. However, keep in mind that this scan does not always show placental abruption.

What are the treatments?

The first thing we need to understand is that a placenta previa cannot be reattached to the uterine wall . Therefore, treatment depends on your gestational age (in weeks), the extent of the placenta previa, and the health of you and your baby.

• If you are less than 34 weeks pregnant: If the placental abruption is not serious and the baby's heartbeat is normal, you will be kept in the hospital for observation. If the bleeding stops, you may be able to go home. Also, because the baby may be born prematurely, you may be given steroids to help the baby's lungs develop quickly.
• If you are more than 34 weeks pregnant: If the bleeding is minor, you may be able to have a vaginal delivery. However, if the condition is severe, meaning your or your baby's life is at risk, you may need to have an emergency cesarean section (C-section) . You may also need a blood transfusion.

What complications can this cause?

This is a serious condition. If only a small part of the placenta separates, it may not be a big problem. But if a large part separates, it can affect both the mother and the baby.

Possible effects on the mother

• Going into shock or needing a blood transfusion due to massive bleeding.
• Problems with the blood clotting system.
• Kidney or other organ failure.
• Very rarely, the mother's life is at risk.

Possible effects on the baby

• Premature birth: A baby born before 37 weeks.
• Developmental problems: Being born prematurely puts the baby at risk of developing health problems later in life.
• Stillbirth: The death of a baby in the womb after 20 weeks of pregnancy.

It's true that these things are scary to hear. But we are aware of them to protect ourselves from them. Many of these complications can be prevented by taking action as soon as symptoms appear.