Normally, the placenta should separate from the uterine cavity once a child has been delivered. Whether the child is delivered through a vaginal delivery or caesarean section, the placenta will be expelled after birth. However, if the child has not yet been born, but the placenta begins to separate, partially or substantially, the placental abruption, as it is known, can become life threatening to both mother and unborn child.
The dangers. The placenta is the channel between mother and fetus, providing the child with nutrients and oxygen. If the placenta separates from the uterine wall, the child can be deprived of these nutrients and oxygen, and it can also lead to heavy blood loss for the mother.
Placental abruption most commonly occurs in the final quarter of pregnancy and can present symptoms in many forms, including vaginal bleeding, stomach pains, uterine tenderness, or frequent contractions.
Placental abruption may result from a trauma to the abdomen, such as from a car accident, a fall, or from the mother-to-be’s waters breaking.
Treatment for placental abruption depends on the severity of the separation of the placenta and on the gestational age. If a partial separation occurs at an early gestational age, and both mother and child have not encountered any abnormalities, the pregnancy can continue as normal, with the condition’s progression being monitored under the close care of an obstetrician. If there is continuous and severe separation, however, the pregnancy should be terminated immediately, which is usually carried out by means of caesarean section.
M.D., Faculty of Medicine, Chulalongkorn University, 2003. Faculty of Medicine Chulalongkorn University