Placenta II

Abruptio Placentae (Accidental Hemorrhage Abruption) is bleeding that occurs when the placenta seperates from the uterine wall. The bleed can be seen as anechoic fluid that may eventually form into a clot, which can exhibit low level echoes or internal debris within the area. Later on, the clot would appear echogenic in ultrasound image.

Abruptio placentae can occur at five different sites of the uterus: intraplacental or infarcts (within the placenta), subplacental/retroplacental (between myometrium and placenta), subchorionic/subamniotic (at edge of placenta--marginal bleed), intraamniotic (within amniotic cavity). Below is an image displaying an example of subplacental bleeding in ultrasound.


Causes of abruptio placentae may be difficult to determine but can be the following: rapid loss of amniotic fluid, trauma, or abnormally short umbilical cord (appear as three straight lines in US). Risk factors include: advanced maternal age, cigarette smoking, diabetes, high blood pressure, increased uterine distension (as seen with multiple pregnancies), abnormally large volume of amniotic fluid (polyhydraminous--most likely due to the fetus having trouble swallowing), or large number of prior deliveries. Symptoms include abdominal pain, back pain, and vaginal bleeding. Usually a C-Section is given if the internal bleeding is severe.