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Are there any predisposing factors to placental abruption?
Yes. Hypertension is the most significant risk factor; this is regardless of whether this is pre-existing or it developed during pregnancy. Other risk factors are:
Ø trauma, especially if it is directly to the abdomen
Ø cigarette smoking
Ø drug abuse, particularly cocaine
Ø older mothers (over thirty five years).
In a significant proportion of affected mothers, no risk factor can be identified.
Does placental abruption recur?
Yes, there is a tendency for this to happen. If you have had one abruption, the risk of this recurring in a subsequent pregnancy is one in twenty, that is about 5 per cent. If it occurs in two consecutive pregnancies, the risk jumps to one in four, i.e. about 25 per cent. Pregnancies following an abruption are regarded as high risk and are managed as such.
Yes, there is a tendency for this to happen. If you have had one abruption, the risk of this recurring in a subsequent pregnancy is one in twenty, that is about 5 per cent. If it occurs in two consecutive pregnancies, the risk jumps to one in four, i.e. about 25 per cent. Pregnancies following an abruption are regarded as high risk and are managed as such.
Can an ultrasound scan diagnose abruption?
The diagnosis of this condition is largely clinical: that is, it depends on the symptoms a woman has and the doctor's findings on examination.
A scan has a very small role to play in diagnosis and will miss the majority of abruption cases. It is, however, useful in verifying the condition of the fetus when the diagnosis is made or suspected.
A scan has a very small role to play in diagnosis and will miss the majority of abruption cases. It is, however, useful in verifying the condition of the fetus when the diagnosis is made or suspected.
A special blood test (Kleihauer) may confirm the diagnosis by identifying the presence of fetal cells in the mother's circulation. However, this test is not specific
What is the method of delivery in placental abruption?
This depends on several factors. If there is significant abruption and the fetus is alive, the only option is an emergency caesarean delivery. Several factors do influence the method and timing of delivery:
Ø Gestational age: if the fetus is severely premature and there is no realistic chance of survival outside the womb, a caesarean section is probably unwise, unless the extent of bleeding makes it unavoidable.
Ø If the bleeding is not continuous but assessment shows that vaginal delivery is unlikely to be achieved in a reasonable space of time, then a caesarean section becomes inevitable.
Ø If the woman is already in labour and the fetal condition is stable, then vaginal delivery may be aimed for.
Ø If the baby is dead and the patient is stable, the strategy is usually a vaginal delivery. If she is not already in labour, this is usually induced.