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Aetiology

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This is unclear. The strongest association is with trauma and hypertension.

Other factors which have been associated with abruption are:

  • past obstetric history of abruptio placentae
  • pregnancy induced or essential hypertension - in up to 25% of patients with abruption
  • multiple pregnancy
  • increasing age
  • high parity
  • low socio-economic status
  • renal infection
  • drugs - smoking, cocaine
  • uterine anomaly or tumour
  • sudden uterine decompression - may endanger the second or subsequent children in multiple births
  • short umbilical cord
  • pressure from the enlarged uterus on the inferior vena cava

It has been suggested also that abruption may be caused by folate deficiency because:

  • abruptio placentae is found more often in multiparous women with low socio-economic status
  • there is an association between megaloblastic anaemia and abruption However:
  • megaloblastic anaemia is common in Nigeria but abruption is not
  • folate supplements are not protective

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