Placental abruption, or the pre-term and pre-delivery detachment of the placenta from the uterine wall, entails the pooling of blood between the detached space of the uterus and placenta, which ultimately presents a high risk for hemorrhaging in the mother. Moreover, pre-term abruption accounts for significantly higher mortality rate for infants at a rate nearly ten times those pregnancies not featuring placental abruption. In this sense, medical professionals should address abruption concerns immediately, whether pre-term or during the labor process as the condition greatly jeopardizes the health of both mother and child.
Placental Abruption Concealed and Revealed
Occurring in a widely varying degree of severity, placental abruption affects less than one percent of live births. However, identification of the abruption requires medical professionals at least considering the possibility. Generally, eighty percent of placental abruption cases manifest as revealed abruptions, with vaginal hemorrhaging indicating this problem at the outset. However, a smaller percentage of cases manifest as concealed, where the hemorrhage in the uterus retains the majority of blood loss, thus leading to patients and professionals misdiagnosing the condition, while also grossly underestimating the amount of blood lost, and by extension, the risks posed to both mother and child. Diagnosis of placental abruption usually requires an ultrasound procedure, but other common methods of identification include fetal hypoxia, uterine discomfort oftentimes described as abdominal pain, but in practice, most women in practice self-identify symptoms via observing vaginal bleeding during pregnancy resulting in an emergency room visit
Known Risk Factors for Placental Abruption
Known to the medical community are a number of relatively commonly risk factors for placental abruption that should be identified by attending physicians over the course of a pregnancy, including:
- Prior pregnancy involving abruption, or a prior delivery via c-section
- Trauma during the pregnancy
- Pregnancies featuring two or more infants simultaneously
- Smoking or prior drug use in the mother
- Pregnancies featuring pre-eclampsia, intrauterine infection, or patient’s exhibiting hypertension
Placental Abruption Treatment
Foremost, until determined otherwise, placental abruption treatment requires immediate medical intervention that seeks to do the following:
- Ascertain the status of the infant, especially in terms of oxygen saturation levels, which is often accomplished by way of various types of blood transfusions
- Determine and control extent of hemorrhaging in the mother
- Assess and determine extent of abruption, which when coupled with viability of delivery, may necessitate premature delivery of the infant.
- If determined that delivery is not viable due to prematurity, professionals will seek to prioritize lung development in the infant by way of administering maternal steroids
Finally, post-treatment monitoring of the mother for post-partum hemorrhaging is essential in cases of placental abruption treatment. However, in most cases, doctors must critically assess the viability of delivery in cases of pre-term placental abruption, while weighing the risks of premature delivery versus the risks associated with the placental detachment from the uterine while, usually in conjunction primarily with concerns over the oxygen saturation levels of the fetus, as well as the potential of hemorrhaging in mind.
Major Complications in Placental Abruption Treatment
From the perspective of a patient, the largest risk stems from the inability of doctors to correctly identify warning signs, risk factors, and symptoms of placental detachment from the outset of the pregnancy, while also passing along this information to the mother. In this sense, even decreased oxygen levels in the child over a short period of time pose grave risks to the long-term development health of the child, while in certain fairly obvious cases, the hemorrhaging immediately jeopardizes the health of the mother and child as well. Thus, failure to receive treatment for placental abruption cases is most likely the most preventable cause of complications from placental abruption treatment. In other cases, delays or responses that are insufficient to meet the severity of the circumstances, when applied to a broader rubric of a reasonable standard of care, may also complicate matters.
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