Abruptio Placentae and its Relations to Maternal and Neonatal Outcomes: A Narrative Review of Recent Literature

Placental abruption (PA) is the premature separation of the placenta from the uterine wall, typically occurring after 20 weeks of gestation. Affecting approximately 1.4% of pregnancies, PA poses significant risks to both maternal and fetal health, including life-threatening complications and increased mortality. The etiology of PA involves chronic and acute pathways such as vasculopathy, inflammation, and oxidative stress, often exacerbated by risk factors like maternal hypertension, advanced age, smoking, and a history of prior abruption. This review aims to explore the multifactorial nature of placental abruption, improving understanding of its diagnosis, management, and prevention strategies. A comprehensive review of the literature was conducted, focusing on the clinical presentation, diagnostic methods, management approaches, and preventive strategies related to placental abruption. Results show diagnosis of PA is primarily clinical, with symptoms including vaginal bleeding, abdominal pain, and uterine contractions, confirmed post-delivery. While ultrasonography is used in diagnosis, its limitations have prompted the use of advanced imaging techniques. Management ranges from expectant monitoring to emergency cesarean delivery, depending on severity. PA is associated with increased risks of postpartum hemorrhage, infection, maternal death, preterm birth, low fetal birth weight, and neonatal respiratory distress. Preventive strategies targeting hypercoagulability with anticoagulants remain inconclusive and are generally not recommended. Lifestyle interventions show potential but require further investigation. The review underscores the importance of understanding PA's multifactorial nature to improve current diagnostic, management, and preventive approaches. Further research into novel interventions is essential for better outcomes.