Placental abruption is a condition in which the placenta partially -- and in some cases almost completely -- peels away from the uterine wall before delivery. It can deprive the fetus of oxygen and, in severe cases, cause bleeding in the mother that endangers both her and the baby.
Abruption occurs in about one in 100 pregnancies, most often in the third trimester, but it can begin any time after 20 weeks of pregnancy. The main symptom is vaginal bleeding, sometimes with uterine discomfort and tenderness, and sudden, continual abdominal pain.
The cause of abruption is unknown, but high blood pressure, cocaine use, and cigarette smoking during pregnancy greatly increase your risk. Other factors that raise your chances of an abruption include trauma and abnormalities of the uterus or umbilical cord, and being over 35 years of age. And if you had an abruption in a previous pregnancy, you have a 10 percent chance of another occurrence.
Mild abruptions (in which only a small part of the placenta peels away from the uterine wall) generally are not dangerous unless they progress. If your abruption does progress, you're bleeding heavily, or your baby is having difficulties, then a prompt delivery, usually by cesarean, probably will be necessary.
If your fetus is too premature to deliver immediately, and tests show that the baby isn't in trouble, your doctor may admit you to the hospital for monitoring. If your doctor suspects that your abruption is likely to result in preterm delivery, she will probably recommend treatment with corticosteroids. These drugs speed maturation of the fetal lungs and other organs and can dramatically cut the incidence of prematurity-related infant deaths and certain complications of early birth.
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