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Desprendimiento prematuro de placenta - Overview

Nombres alternativos

Separación prematura de la placenta; Abrupción placentaria; Desprendimiento placentario; Ablación de la placenta

Definición:

Es la separación de la placenta (el órgano que alimenta al feto) de su adhesión a la pared uterina antes de dar a luz al bebé.

Causas, incidencia y factores de riesgo:

La causa exacta del desprendimiento prematuro de la placenta puede ser difícil de determinar.

Las causas directas son poco comunes, pero abarcan:

  • Lesión en el área ventral (abdomen) a raíz de una caída, un golpe en el abdomen o un accidente automovilístico
  • Pérdida súbita del volumen uterino (puede ocurrir con la pérdida rápida del líquido amniótico o después del parto de un primer gemelo)

Entre los factores de riesgo se pueden mencionar:

  • Trastornos de la coagulación de la sangre (trombofilias)
  • Tabaquismo
  • Consumo de cocaína
  • Diabetes
  • Beber más de 14 tragos de alcohol por semana durante el embarazo
  • Presión arterial alta durante el embarazo (aproximadamente la mitad de los casos de desprendimiento prematuro de placenta que llevan a la muerte del bebé están asociados con hipertensión arterial).
  • Antecedentes de desprendimiento prematuro de placenta
  • Aumento de la distensión uterina (puede ocurrir con embarazos múltiples o un volumen muy grande de líquido amniótico)
  • Gran número de partos anteriores
  • Edad avanzada de la madre
  • Ruptura prematura de membranas (la bolsa de agua se rompe antes de las 37 semanas en el embarazo)
  • Miomas uterinos

El desprendimiento prematuro de la placenta, que incluye cualquier separación de la placenta previa al parto, ocurre en aproximadamente 1 de cada 150 partos. La forma grave, que puede provocar la muerte del bebé, se presenta únicamente en alrededor de 1 por cada 800 a 1,600 partos.

  • 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.

Referencias

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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