OB Nursing 101: The Dangers of Abruptio Placenta

One of the most common yet most dangerous complications of bearing a child is abruption placenta. But what is abruptio placenta and how can the healthcare team manage this kind of condition?

Normal Placenta

Having a general point-of-view on the normal situation will provide a further understanding of the about complication; therefore, before going into what abruptio placenta is, let’s take a quick look at a normal placenta.

A placenta develops during pregnancy inside the womb of the mother by attaching to the uterine wall. The main function of a placenta is to nourish the fetus. Through the umbilical cord, the placenta supplies the growing and developing fetus with oxygen and nutrients throughout the course of staying inside the uterus.

Defining Abruptio Placenta

Abruptio placenta, or placental abruption, is a sudden stop or disconnection. There are two types of abruptio placenta – partial and complete. Whether it’s partial or complete, the placenta will separate from the wall of the uterus before the mother gives birth. Full placental separation is considered lethal because it can lead to serious consequences like death of the fetus.

Factors that Trigger Abruptio Placenta

There are a couple of factors that can heighten the risk of abruptio placenta, namely:

• Smoking
• Drugs (Cocaine)
• Severe hypertension
• Trauma caused by accidents or fall

Any of these factors that happen during pregnancy can cause abruptio placenta, thereby endangering the life of the fetus.

Abruptio Placenta: Pain

One of the prominent manifestations that pregnant clients might be suffering from placental abruption is the insurmountable amount of pain. What causes this pain? Think of abruptio placenta as a scab being pulled off of the uterine wall which is severely painful.

Abruptio Placenta: Bleeding

Bleeding in abruptio placenta depends whether it’s partial or complete separation. In partial abruptio placenta, only a portion of the placenta is sloughed off the uterine wall, possibly underneath or around the area of separation.

Bleeding can lead to hypovolemic shock because there’s not a lot of volume within the blood vessels. This type of bleeding is usually internal; therefore signs of external bleeding would not be apparent.

Assessing Abruptio Placenta

There are a couple of things that you have to ask yourself when performing an abdominal assessment on a client suspected of abruptio placenta, and these questions are:

1. Does the client have a hard abdomen?
2. Is the blood pressure going down?
3. Is the heart rate going up?

If the answer to all of these questions is, “yes,” then the client is most likely having an abruptio placenta.

Signs and Symptoms

Internal bleeding, as previously stated, is the most prominent manifestation of abruptio placenta. Late decelerations and decreased fetal heart rate with signs of bradycardia are also the primary signs and symptoms of abruptio placenta.

Management

If the fetus is already stressed out and severely compromised, the main medical management for this type of situation is to immediately perform a C-section. This decision can be quite difficult and critical especially if the baby is in its eight weeks earlier from its estimated date of delivery.

An early delivery would result in a very premature and weak baby. Expect a lot of newborn complications due to underdeveloped organs.

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