Placental Abruption
Overview
Plain-Language Overview
Placental abruption is a serious pregnancy complication where the placenta separates from the uterus wall before delivery. This condition affects the reproductive system and can cause significant problems for both the mother and baby. The main issue is that the placenta, which provides oxygen and nutrients to the baby, stops working properly. This can lead to heavy vaginal bleeding, abdominal pain, and premature birth. It is an emergency because it can reduce oxygen supply to the baby and cause severe blood loss in the mother. The severity depends on how much of the placenta detaches and how quickly it happens.
Clinical Definition
Placental abruption is defined as the premature separation of a normally implanted placenta from the uterine wall after 20 weeks of gestation but before delivery. The core pathology involves bleeding into the decidua basalis, leading to partial or complete detachment of the placenta. This separation disrupts maternal-fetal exchange, causing fetal hypoxia and maternal hemorrhage. The usual mechanism includes rupture of maternal vessels in the decidua, often triggered by trauma, hypertension, or vascular disease. Clinically, it presents with vaginal bleeding, uterine tenderness, and abdominal pain. It is a major cause of perinatal morbidity and mortality due to fetal distress and maternal hemorrhagic shock. Diagnosis and management are critical to prevent adverse outcomes.