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Placenta abruptio - Overview

Alternative Names

Premature separation of placenta; Ablatio placentae; Abruptio placentae; Placental abruption

Definition of Placenta abruptio:

Placenta abruptio is the separation of the placenta (the organ that nourishes the fetus) from its attachment to the uterus wall before the baby is delivered.

Causes, incidence, and risk factors:

The exact cause of a placental abruption may be hard to determine.

Direct causes are rare, but include:

  • Injury to the belly area (abdomen) from a fall, hit to the abdomen, or automobile accident
  • Sudden loss of uterine volume (can occur with rapid loss of amniotic fluid or after a first twin is delivered)

Risk factors include:

  • Blood clotting disorders (thrombophilias)
  • 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 (may occur with multiple pregnancies or very large volume of amniotic fluid)
  • Large number of past deliveries
  • Older mother
  • Premature rupture of membranes (the bag of water breaks before 37 weeks into the pregnancy)
  • Uterine fibroids

Placental abruption, which includes any amount of placental separation before delivery, occurs in about 1 out of 150 deliveries. The severe form, which can cause the baby to die, occurs only in about 1 out of 800 to 1,600 deliveries.

  • Reviewed last on: 11/21/2010
  • Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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, Salhi BA. Acute complications of pregnancy. In: Marx J, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 176.

Cunningham FG, Leveno KL, Bloom SL, et al. Obstetrical hemorrhage. In: Cunningham FG, Leveno KL, Bloom SL, et al., eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill: 2010:chap 35.

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