Definition:
Placenta abruptio is separation of the placenta (the organ that nourishes the fetus) from the site of uterine implantation before delivery of the fetus.
Alternative Names:
Premature separation of placenta; Ablatio placentae; Abruptio placentae; Placental abruption
Causes, incidence, and risk factors:
The exact cause of a placetal abruption may be difficult to determine. Direct causes are rare, but include: Abnormally short umbilical cord Injury to the belly area (abdomen) from a fall or automobile accident Sudden loss in uterine volume (can occur with rapid loss of amniotic fluid or the delivery of a first twin)
Risk factors include: Advanced maternal age - Cigarette smoking
- Cocaine use
- Diabetes
- Drinking more than 14 alcoholic drinks per week during pregnancy
- High blood pressure during pregnancy -- About half of placental abruptions that lead to the baby's death are linked to high blood pressure
- History of placenta abruptio
- Increased uterine distention (as may occur with multiple pregnancies or abnormally large volume of amniotic fluid)
- Large number of prior deliveries
Placenta abruptio, including any amount of placental separation prior to delivery, occurs in about 1 out of 150 deliveries. The severe form, which results in fetal death, occurs only in about 1 out of 500 to 750 deliveries.
References:
Francois KE, Foley MR. Antepartum and postpartum hemorrhage. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics - Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2007:chap 18. Houry DE, Abbott JT. Acute complications of pregnancy. In: Marx J, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 6th ed. St Philadelphia, Pa: Mosby Elsevier; 2006:chap 177.
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