Placental Abruption

Placental abruption is a condition in which the placenta partly or completely separates from the uterus before the baby is born. The placenta is the organ that nourishes the unborn baby (fetus). The baby gets his or her blood supply and nutrients through the placenta. It is the baby’s life support system. The placenta is attached to the inside of the uterus until after the baby is born.

Placental abruption is rare, but it can happen any time after 20 weeks of pregnancy. A small separation may not cause problems, but a large separation may be dangerous for you and your baby. A large separation is usually an emergency. It requires treatment right away.

What are the causes?

In most cases, the cause of this condition is not known.

What increases the risk?

This condition is more likely to develop in women who:

• Have experienced a recent trauma such as a fall, an abdominal injury, or a car accident.
• Have a previous placental abruption.
• Have high blood pressure (hypertension).
• Smoke cigarettes, use alcohol, or use illegal drugs such as cocaine.
• Have blood clotting problems.
• Experience preterm premature rupture of membranes (PPROM).
• Have multiples (twins, triplets, or more).
• Have had children before.
• Are 35 years of age or older.

What are the signs or symptoms?

Symptoms of this condition can vary from mild to severe.

A small placental abruption may not cause symptoms, or it may cause mild symptoms, which may include:

• Mild abdominal pain or lower back pain.
• Slight vaginal bleeding.

A severe placental abruption will cause symptoms. The symptoms will depend on the size of the separation and the stage of pregnancy. They may include:

• Abdominal pain or lower back pain.
• Vaginal bleeding.
• Tender and hard uterus.
• Severe abdominal pain with tenderness.
• Continual contractions of your uterus.
• Weakness and light-headedness.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms.
• A physical exam.
• Ultrasound.
• Blood work. This will be done to make sure that there are enough healthy red blood cells and that there are no clotting problems or signs of too much blood loss.

How is this treated?

Treatment for placental abruption depends on the severity of the condition.

For mild cases, treatment may involve monitoring your condition and managing your symptoms. This may involve:

• Bed rest and close observation.

For more severe cases, emergency treatment is needed. This may involve:

• Staying in the hospital until you and your baby are stabilized.
• Cesarean delivery of your baby.
• A blood transfusion or other fluids given through an IV tube.
• Other treatments, depending on:
  • The amount of bleeding you have.
  • Whether you or your baby are in distress.
  • The stage of your pregnancy.
  • The maturity of the baby.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider. Do not take any medicines that your health care provider has not approved.
• Arrange for help at home before and after you deliver your baby, especially if you had a cesarean delivery or if you lost a lot of blood.
• Get plenty of rest and sleep.
• Do not use illegal drugs.
• Do not drink alcohol.
• Do not have sexual intercourse until your health care provider says it is okay.
• Do not use tampons or douche unless your health care provider says it is okay.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.

Get help right away if:

• You have vaginal bleeding or spotting.
• You have any type of trauma, such as a fall, abdominal trauma, or a car accident.
• You have abdominal pain.
• You have continuous uterine contractions.
• You have a hard, tender uterus.
• You do not feel the baby move, or the baby moves very little.