Among the many complications pregnant women may experience is placental abruption. Placental abruption is known to have a possibility of depriving the baby of oxygen and nutrients, and cause heavy bleeding for the mother. If doctors discover this condition, they can advise early delivery, in some cases. Dr Stephen Rulisa, an obstetrician-gynaecologist at University Teaching Hospital of Kigali (CHUK), says that placental abruption is a term that refers to premature separation of the placenta from the uterus. Better Health Channel, a health platform, states that placental abruption means that the placenta has detached from the wall of the uterus, either partly or totally. This can cause bleeding for the mother. It may also interfere with the unborn baby’s supply of oxygen and nutrients, which the placenta provides from the mother’s bloodstream through the lining of the uterus. “Doctors cannot reattach the placenta. Without prompt medical treatment, a severe case of placental abruption can have terrible consequences for the mother and her unborn child, including death. “Worldwide, placental abruption occurs in about one pregnancy in every 100. In about half of the cases, placental abruption is mild and can be managed by ongoing close monitoring of the mother and baby. About 25 per cent of cases are moderate, while the remaining 25 per cent threaten the life of both the baby and mother,” Better Health Channel indicates. Dr Iba Mayele, an obstetrician-gynaecologist at Clinic Galien in Kimironko, explains that doctors sometimes don’t know the exact cause of placental abruption. They assume that abnormal blood supply in the uterus or placenta may be the cause, though the cause isn’t entirely clear. Some of the known causes of placental abruption, he says, may include, abdominal trauma – an injury to the pregnant woman’s abdomen that may pull apart the placenta from the wall of the uterus. Or uterine decompression (a quick loss of amniotic fluid from the uterus, which can pull the placenta from the uterus wall, probably due to a birth of the first twin (or multiple) or separation of amniotic membranes due to extreme amniotic fluid). The amniotic fluid is a clear, slightly yellowish liquid that surrounds the unborn baby (foetus) during pregnancy. “Once pregnant women notice that they are bleeding, have incessant abdominal pain, throbbing abdomen, gentle and hard uterus, recurrent uterine contractions or foetal pain, for instance, abnormal heart rhythm, then it is evident enough that they could be suffering from placental abruption,” Mayele says. Rulisa says that usually, common causes are trauma, like a brunt injury to the abdomen, falling, accidents and other causes such as hypertension, smoking, rupturing membrane rapidly, among others. He also notes that the risk factors are really unknown, but common ones are smoking and maternal high blood pressure, old age, and multiple pregnancies. Mayele points out that the condition causes some complications when severe, which are; diminished oxygen to the baby—this can damage the brain. Others difficulties could be maternal blood loss which can result in shock, miscarriages, surgical removal of the uterus that is known as emergency hysterectomy, cases where the bleeding cannot be controlled, and at worst, maternal death from severe blood loss. Rulisa highlights that diagnosis is usually clinical, characterised abdominal tenderness (pain) and rigidity, abdomen (uterus) is very hard and vaginal bleeding may occur but not always. Although it is next to impossible to prevent placental abruption, the risk can be minimised through evading all substances during pregnancy, for example cigarettes, alcohol, medicines (except prescribed by your doctor) and drugs, Mayele emphasises. He also urges pregnant women to lessen their risk of trauma, control high blood pressure by checking with the doctor for information, advice and treatment, where need be. Mayele also says, don’t hesitate to talk with your doctor if you have had placental abruption in a preceding pregnancy, and make it a point to take folic acid as suggested by your doctor or midwife.
