Placental abruption, also called abruptio placentae, describes the separation of the placenta from the wall of the uterus between week twenty and delivery.
The placental abruption results in a reduced flow of oxygen and blood to the fetus and in severe cases may result in the death of the baby. The risks to the mother include shock, and the inability of the blood to clot resulting in severe blood loss.
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The area where the placentaThe placenta is a large disk shaped membrane responsible for providing nourishment to the fetus during pregnancy. It consists of three parts, the fetal part made up from the chorion membrane surrounding the fetus, the maternal part, formed from the decidua basalis layer of the uterine lining, and the intervillous space between the two plates. It is connected to the fetus by the umbilical cord and consists of tissue from both the mother and the embryo.
Its function is complex. It has been described as a simple organ that combines the functions of a kidney-dialysis machine, heart and lung machine and intravenous drip. It consists of enormous numbers of blood vessel branches that permit the exchange of nutrition and oxygen, from the mother's bloodstream to the fetus and the removal of wastes to the mother to be excreted. The placenta's remarkable quality is that it does so without the blood of the mother mixing with that of the baby.
It also is responsible for the production of vital hormones including, estrogen, progesterone, and human chorionic gonadotropin. After birth, the placenta is delivered, and is sometimes referred to as the afterbirth.
Visit our comprehensive glossary for more pregnancy terms and definitions. attaches to the uterine wall is filled with blood vessels and separation is likely to result in bleeding. In about one third of cases the separation is small and the resuting hemorrhage may be concealed by the rest of the placenta which is still attached to the uterus.
The majority of cases will result in heavy vaginal bleeding. Other signs of placental abruption include severe abdominal pain, lower back pain, and in some cases uterine contractions and premature labor. In some cases it has been possible to diagnose placental abruption using ultrasound although the results are not always accurate.
placental abruption occurs in about one percent (1 in 100) pregnancies. The incidence does not seem to change with age, but lifestyle choices such as smoking or drug abuse does increase the risk.
There are a number of risk factors that contribute to placental abruption. Some of these are obstetrical complications, while others are nutrional or accidental. Medical causes include:
Other causes of placental abruption include:
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Some doctors now believe that a contributory factor is insufficient folic acidA water soluble vitamin with a yellow crystalline construction of the B complex group. Folic acid is necessary for cell growth and reproduction. It works with vitamins B12 and C to breakdown and use proteins, and helps form nucleic acids and heme in hemoglobin.
Folic acid also stimulates the appetite and the production of hydrochloric acid in the digestive tract. It is stored in the liver. Important in pregnancy, natural sources include green leafy vegetables, liver, kidney, asparagus, lima beans, nuts and whole grain cereals. It may also help alleviate menstrual problems. Also known as folacin.
Visit our comprehensive glossary for more pregnancy terms and definitions. in the diet. Your doctor will be monitoring your pregnancy and may advise you to increase your folic acid intake as your pregnancy progresses. If you drink alcohol or smoke you will be asked to stop to reduce the risk of placental abruption.
The course of treatment will depend on the severity of the abruption. In the most severe cases where signs of fetal distress are noticed your doctor will perform an emergency cesarean section to deliver the baby and treat the hemorrhage.
In most cases the placental abruption will lead to uterine contractions and premature labor. If the detached area is small your doctor will probably recommend monitoring the placental abruption and the development of the fetus so that it can continue to grow in utero.
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