From the Research
Placental abruption is most common at term gestations, with nearly half of abruption occurring at this stage, as indicated by the most recent study 1. The risk of placental abruption increases as pregnancy progresses, with the highest rates occurring closer to term. This timing pattern relates to the physiological changes in the placenta and uterus as pregnancy advances. As the placenta matures and the uterus continues to stretch to accommodate the growing fetus, the interface between the placenta and uterine wall becomes more vulnerable to separation, especially in the presence of risk factors such as hypertension, trauma, substance use (particularly cocaine), or a history of previous abruption. Some key points to consider include:
- The prevalence of placental abruption is lower in the Nordic countries (0.38-0.51%) compared with the USA (0.6-1.0%) 2.
- Placental abruption is also one of the most important causes of maternal morbidity and perinatal mortality, with maternal risks including obstetric hemorrhage, need for blood transfusions, emergency hysterectomy, disseminated intravascular coagulopathy, and renal failure 2.
- Gestational age at delivery, birthweight, and history of recent trauma are significantly associated with perinatal mortality, with a perinatal mortality rate of 42% in patients who delivered prior to 30 weeks of gestation compared to 15% in patients who delivered after 30 weeks of gestation 3. Clinicians should maintain heightened vigilance for symptoms like vaginal bleeding, abdominal pain, and uterine tenderness during this critical period, as prompt recognition and management are essential to improve maternal and fetal outcomes.