Pregnancy Problems

Placental Abruption

Answers to all your questions about placental abruption.

What is placental abruption?

The placenta is your baby’s life support system, and it’s meant to stay attached to the uterus right up through delivery. In a placental abruption, the placenta separates away from the wall of the uterus, disrupting the flow of oxygen and important nutrients from you to your baby.

What are the signs of a placental abruption?

Abdominal pain, back pain, frequent uterine contractions (or contractions without any break in between) and vaginal bleeding are all signs of an abruption.

Are there any tests for a placental abruption?

If your doctor suspects you have placental abruption, she’ll likely order an abdominal or vaginal ultrasound, as well as fetal monitoring and blood tests.
 
How common is a placental abruption?

The condition (either partial or full tear) occurs in about 1 out of 100 to 150 deliveries. The more severe form (a full tear) occurs in about 1 out of 800 to 1,600 deliveries.

How did I get a placental abruption?

The exact cause can be difficult to determine, but a direct trauma to the abdomen (such as in an automobile accident or a fall) can cause the placenta to tear from the uterine wall. Other risk factors include diabetes, smoking, high blood pressure, cocaine use or drinking more than 14 alcoholic beverages a week during pregnancy, as well as an older maternal age, a large number of previous deliveries, uterine fibroids or increased uterine distention (which can happen if you’re carrying multiples or have a large volume of amniotic fluid).

How will my placental abruption affect my baby?

A placental abruption is a true obstetrical emergency, and it can result in death for the baby — and in some instances (excessive blood loss, hidden uterine bleeding), the mother. So seek medical help immediately (see next page for treatments).

What’s the best way to treat a placental abruption?

If the tear is only a partial one, you’ll be monitored carefully for signs of fetal distress (such as an abnormal heart rate) and may receive blood transfusions. If the tear is more significant, you may need an emergency c-section.

What can I do to prevent a placental abruption?

There’s not much you can do to prevent an accident or trauma, but avoid alcohol, cigarettes and recreational drugs (but you already knew that). If you had high blood pressure or diabetes before pregnancy, see a maternal fetal medicine specialist who can keep close tabs on your progress. 
 
What do other pregnant moms do when they have a placental abruption?
 
“I had a placental abruption at 27 weeks but felt no pain from the abruption itself. Just started bleeding somewhat heavily and had contractions by the time I was admitted to the hospital. The abruption was confirmed via ultrasound and had caused a clot that was so large, I was rushed into an emergency c-section.”

“I had a partial abruption at 32 weeks. I got up to go to the bathroom right after going to bed, and there was a large gush of blood. There was some minor clotting, but not much. I was given the steroid shots. I was admitted to the OB special care ward but only had to stay two days, as the bleeding had stopped. I was released on strict bed rest and then, after a few more days, modified bed rest.”

“I had a partial abruption caused by an intrauterine infection. I didn’t feel anything. I was admitted at 24 weeks when I started having some pretty major bleeding. I was also having contractions and was 2 centimeters dilated, 100 percent effaced. I was given the steroid shots and on mag for three or four days. I started having more bleeding and contractions as the week progressed, and my DS was born at 25 weeks, 4 days.”
 
Are there any other resources for placental abruption?
 
March of Dimes

Plus, more from The Bump:

What does the placenta do? 

What are placenta conditions?

What does going on bed rest really mean?

By Robert Wool, board-certified ob-gyn at Women’s Health Associates in Westfield, MA