• Baby on the Way

Heed the Signs of Placental Abruption

If you’re pregnant and have any bleeding, tell your doctor and get checked out immediately. If you’re bleeding after 20 weeks, it could be caused by placental abruption.

Placental abruption is when your placenta separates from the wall of your uterus, whether in part or completely. The placenta is attached to the wall of your uterus, and gives blood, nutrients and oxygen to your baby. It normally grows at the top of your uterus and separates during the last stage of labor. If it separates too early, your baby may not receive enough oxygen and nutrients, which may cause serious side effects.

The main sign of placental abruption is dark, heavy vaginal bleeding.

Who is at Risk?

Around one in 100 pregnant women have a placental abruption. No one really knows why it happens, but you may be more at risk if you:

• Use cocaine during pregnancy
• Smoke
• Have had a placental abruption in a previous pregnancy
• Are over age 35
• Are pregnant with multiples
• Have pre-eclampsia or hypertension
• Experience your water breaking before 37 weeks
• Have sickle cell anemia
• Have an abnormal uterus
• Have abdominal trauma (like a car accident or abuse)

Can Placental Abruption Be Prevented?

Since the cause of placental abruption is unknown, it’s impossible to say how to prevent it. In general, avoid the risk factors as much as possible. And, when you’re in the car, always wear your seatbelt to try to prevent abdominal trauma during an accident.

What are the Signs?

The main sign of placental abruption is dark, heavy vaginal bleeding. (However, 20 percent of women have no bleeding, since the placenta may trap the blood in the uterus). Other signs include:

• Abdominal pain
• Tenderness around the uterus
• Changes or distress in the baby’s heart rate
• Contractions coming close together

If you have any of these signs, your doctor can diagnose you through a physical exam and an ultrasound.

Doctors divide abruptions into levels of seriousness:

• Grade 1: Minimal bleeding and small contractions, but no fetal distress or issues of blood pressure.
• Grade 2: Mild to medium bleeding, contractions and possible signs of distress in the baby.
• Grade 3: Medium to severe (or hidden) bleeding, continuous contractions, low blood pressure and the potential stillbirth of the baby.

How is Placental Abruption Treated?

Unfortunately, it’s not possible to reattach the placenta to the uterus. So, treatment for placental abruption depends on whether it is a partial or total separation, how far along you are in your pregnancy and the health of your baby.

For example, if you are 24 to 34 weeks along with a partial separation, you may be prescribed monitoring and bed rest. If it’s a total separation, the safest option is delivery of the baby. If the baby is stable, you may be able to have a vaginal birth. If not, you will need a C-section. If you lose a lot of blood, you may need a blood transfusion.

The bottom line is that if you experience any bleeding after 20 weeks of pregnancy, you need to call your doctor right away. Bleeding may be caused by different issues, but if it is placental abruption, rapid care can make a difference.

Source: March of Dimes; American Pregnancy Association