Placenta abruptio is the premature separation of the placenta from the site of uterine implantation after the 20th week of gestation and before the delivery of the fetus. In most pregnancies, the placenta remains firmly attached to the uterus and is expulsed within minutes to an hour following the delivery of the newborn (also known as the 'afterbirth'). Placenta abruptio occurs up to 1 of every 150 deliveries.
Risk factors associated with placenta abruptio include:
Chronic high blood pressure (hypertension)
Pregnancy induced hypertension
History of a prior placenta abruptio
Large number of prior deliveries
Heavy alcohol ingestion
Previous uterine scar
Trauma to the uterus
Symptoms associated with placenta abruptio include:
Abdominal pain (hard, rigid feeling uterus)
Back pain and uterine tenderness
Abnormal uterine contractions
Unexplained premature labor
Vaginal bleeding (light or heavy)
Concealed placenta abruptio may not have vaginal bleeding until late in the process
Tests used to diagnose a placenta abruptio include:
CBC (complete blood count)
Treatment of placenta abruptio requires careful monitoring of the mother and the fetus. The mother should be monitored for signs and symptoms of shock. Blood loss due to the placenta abruptio may be concealed behind the placenta and not be visible as vaginal bleeding. Fluid replacement intravenously and blood transfusion may be required to replace blood loss. The fetus must be closely monitored for signs of fetal distress. The severity of fetal distress corresponds with the degree of placental separation.
If the fetus' maturity is confirmed, an emergency cesarean section may be indicated. If the fetus is immature and the mother's condition is stable, close observation is sometimes utilized. Excessive blood loss resulting in shock can range from mild to severe. Intrauterine fetal death and/or maternal death have been reported as complication of a severe placenta abruptio.
The key to successful treatment of a pregnant patient suffering a placenta abruptio is early diagnosis. Delay in diagnosis and treatment leads to a cascade of complications and inevitable fetal death. At times, immediate cesarean section is the only available alternative to preserve the health of mother and fetus.
If the child's injury was the result of intrauterine fetal hypoxia (asphyxia) secondary to a placenta abruptio, it was diagnosable, avoidable, preventable and treatable. The injury may be the result of a medical provider's mistake in handling an obstetrical condition. Your child and you as parents of the child are entitled to receive compensation. If your child's condition was the result of medical negligence, allow Dr. Borten and the Boston area medical malpractice attorneys at Gorovitz & Borten help you assert your rights and get the compensation you deserve.
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