Q: Dr, your programmes are wonderful. During delivery of my baby girl two years ago, I had placental abruption. It came with severe bleeding. I want to know if there is a possibility of it recurring in my next delivery and if so, how can I avoid it. God bless you.

A: Amen! God bless you too!
The placenta is an ‘organ’ which develops during pregnancy, attached to the side of the uterus and is the means of transport of nutrients and oxygen to the baby and transport of wastes out of the baby via the umbilical cord. So, the placenta is absolutely essential during pregnancy. It maintains its position, normally during pregnancy until the baby is born and the placenta is then delivered.

In the situation described above, placental abruption, the placenta separates, completely or partially, from the wall of the uterus before the baby is born. This situation is not very common but when it does happen, it can deprive the baby of vital nutrients and oxygen and lead to bleeding in the mother. This situation may happen suddenly or may develop gradually with symptoms like vaginal bleeding, abdominal and/or back pain, sore uterus, fewer baby movements, contractions etc

We don’t really know the cause of placental abruption apart from the fact that it could be caused by trauma to the abdomen. Other risk factors include:
• A previous history of placental abruption
• Multiple pregnancy
• Premature rupture of membranes
• Substance abuse eg smoking
• Maternal age greater than 40 years

Now, remember that having a risk factor doesn’t automatically mean that you will come down with the ‘disease’.

Treatment depends on the severity of the abruption, the age of the pregnancy and the effect on the baby. Your doctor will make the call as to whether to go for an emergency Caesarian Section or keep patient on bed rest while waiting for baby to mature some more, depending on these factors.

Can this be prevented? Well, given the fact that we’re not quite sure of the cause, we can’t really do much other than try to guide against risk factors that can be prevented like not smoking.
Just be sure to let your doctor know that you have had this problem before so he can be extra watchful. With the right care, you should be fine.

By the way, if you’re in Nigeria and a Nigerian, I hope you have your PVC. Be sure to use it and take a stand for the kind of government you want. No violence, please!!!

Have a good night, y’all 😀